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

Diabetes Pearl from the Parelsnoer Initiative, S van Oort*, F Rutters, M F Warlé-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 Özcan, H W de Valk, B Silvius, M A Schroijen, I M Jazet, A J van Ballegooijen, J W J BeulensP J Elders, C Kramers

*Corresponding author for this work

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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 numbere14406
Number of pages10
JournalDiabetic Medicine
Volume38
Issue number4
Early online date22-Sep-2020
DOIs
Publication statusPublished - Apr-2021

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