Characteristics associated with polypharmacy in people with type 2 diabetes: the Dutch Diabetes Pearl cohort

S. van Oort*, F. Rutters, M. F. Warle-van Herwaarden, M. T. Schram, C. D. Stehouwer, C. J. Tack, E. J. Abbink, B. H. Wolffenbuttel, M. M. van der Klauw, J. H. DeVries, S. E. Siegelaar, E. J. Sijbrands, B. Ozcan, H. W. de Valk, B. Silvius, M. A. Schroijen, I. M. Jazet, A. J. van Ballegooijen, J. W. J. Beulens, P. J. EldersC. Kramers

*Corresponding author for this work

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2 Citations (Web of Science)

Abstract

Aim To describe the prevalence and characteristics of polypharmacy in a Dutch cohort of individuals with type 2 diabetes. Methods We included people with type 2 diabetes from the Diabetes Pearl cohort, of whom 3886 were treated in primary care and 2873 in academic care (secondary/tertiary). With multivariable multinomial logistic regression analyses stratified for line of care, we assessed which sociodemographic, lifestyle and cardiometabolic characteristics were associated with moderate (5-9 medications) and severe polypharmacy (>= 10 medications) compared with no polypharmacy (0-4 medications). Results Mean age was 63 +/- 10 years, and 40% were women. The median number of daily medications was 5 (IQR 3-7) in primary care and 7 (IQR 5-10) in academic care. The prevalence of moderate and severe polypharmacy was 44% and 10% in primary care, and 53% and 29% in academic care respectively. Glucose-lowering and lipid-modifying medications were most prevalent. People with severe polypharmacy used a relatively large amount of other (i.e. non-cardiovascular and non-glucose-lowering) medication. Moderate and severe polypharmacy across all lines of care were associated with higher age, low educational level, more smoking, longer diabetes duration, higher BMI and more cardiovascular disease. Conclusions Severe and moderate polypharmacy are prevalent in over half of people with type 2 diabetes in primary care, and even more in academic care. People with polypharmacy are characterized by poorer cardiometabolic status. These results highlight the significance of polypharmacy in type 2 diabetes.

Original languageEnglish
Article number14406
Number of pages10
JournalDiabetic Medicine
Volume38
Issue number4
Early online date17 Oct 2020
DOIs
Publication statusPublished - Apr 2021

Keywords

  • MEDICATION USE
  • OLDER
  • COMORBIDITY
  • OUTCOMES
  • ADULTS

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