Effects of pharmacist intervention on polypharmacy in patients with type 2 diabetes in Japan

Horii, Takeshi; Atsuda, Koichiro

doi:10.1186/s13104-020-05032-2

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…The age of patients also affects the prevalence of diabetes and polypharmacy. The duration of the disease becomes longer as the patient becomes elderly and causes the presence of more comorbidities and polypharmacy [24]. In this study, 55 (36.7%) of participants were more than 60 years old, while 42 (44.68%) of the polypharmacy groups were also found in this age group.…”

Section: Discussionmentioning

confidence: 52%

Assessment of Polypharmacy among Diabetic Patients in Tertiary Care Hospital of Nepal

Yadav¹,

Acharya²,

Chhetri³

et al. 2023

Janaki Med. Coll. J. Med. Sci.

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Background & Objective: Diabetes mellitus is a long-term metabolic condition that is accompanied by co-morbidities. Patients therefore use anti-diabetic medications in addition to other medications. Treatment with numerous drugs involves many hazards in addition to effectiveness. Therefore, diabetic people use multiple medications. The main aims of this study were to find out the prevalence of polypharmacy and the factors responsible for polypharmacy, and the consequences of polypharmacy. Material and Methods: A prospective observational study was conducted at the outpatient department of the Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal from 12th February to 31st March 2021. A total of 150 patients who met the inclusion criteria and agreed to give written informed consent were enrolled in this study. A pre-validated questionnaire was used to assess polypharmacy among diabetic patients. The Statistical Package for Social Sciences (SPSS) software version 20 was used to enter and analyze data. Results: A total of 150 diabetic patients were included in this study. Among them, about 62.66% had polypharmacy. Age and duration of disease were highly significant with polypharmacy. Coexisting chronic conditions were highly associated with polypharmacy, like cardiovascular (AOR=5.552), musculoskeletal (AOR=5.050), mental (AOR=7.835), and digestive (AOR=3.778). The most common oral anti-diabetic agent was metformin. Conclusion: Polypharmacy was highly prevalent among diabetic patients. The rate of polypharmacy increases as the age and duration of disease increases. Polypharmacy has many consequences, like adverse drug events, increased costs, decreased compliance, and decreased quality of life.

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Section: Discussionmentioning

confidence: 52%

Assessment of Polypharmacy among Diabetic Patients in Tertiary Care Hospital of Nepal

Yadav¹,

Acharya²,

Chhetri³

et al. 2023

Janaki Med. Coll. J. Med. Sci.

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“…As a result, this approach resulted in a reduction in the number of medications, PIMs, and drug costs. Previous studies have reported that pharmacist interventions have reduced the number of medications, [16][17][18] reduced the ADRs, 19) and improved patient QOL. 20) Our results support the utility of pharmacist intervention for polypharmacy.…”

Section: Discussionmentioning

confidence: 98%

Efficacy of a Pharmacist Team Clinical Medication Review in Older Adults: A Prospective and Retrospective Observational Study

Hatano

Mizuno

Arakawa

et al. 2022

Biological & Pharmaceutical Bulletin

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Polypharmacy in older adults causes problems such as increased adverse drug reactions, overdose or duplication, and poor medication adherence. We have established a "medication review team" organized by pharmacists. This prospective and retrospective observational study evaluated the effectiveness of the pharmacist-led team-based approach for reducing polypharmacy as compared to the individual pharmacist approach. Data on the individual pharmacist approach were collected retrospectively, but prospectively for the pharmacist-led team approach. The study included patients who were admitted to the nephrology, orthopedic surgery, and psychiatry wards. Characteristics for patient included in each study group were adjusted using the propensity score method. The pharmacist-led team approach had a significantly higher medication change rate compared to that of the individual pharmacist approach (odds ratio (OR), 2.28; 95% confidence interval (CI), 1.21 to 4.46; p 0.009). The rate of patients with two or more medication discontinuations and the rate of patients with intervention by young clinical pharmacist were also significantly higher in the pharmacist-led team approach (OR, 2.19; 95% CI, 1.06 to 4.74; p 0.03 and OR, 5.67; 95% CI, 1.22 to 53.15; p 0.02, respectively). The rate of patients with discontinuation of potentially inappropriate medications was not significantly different between the two groups (OR, 2.07; 95% CI, 0.86 to 5.33; p 0.11). Our results suggest that it is possible to improve the quality of medication review by conducting team conferences even with only pharmacists.

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“…Medications increase the healthcare cost of the diabetic subjects [26]. Accordingly, attempts to prevent polypharmacy in the diabetic population significantly reduced the healthcare costs according to a study from Japan [27]. Treatment non-adherence not only prevents diabetic patients from reaching target blood sugar levels, but may also lead physicians to prescribe more medications to ensure diabetic regulation.…”

Section: Discussionmentioning

confidence: 99%

Control Level of Type 2 Diabetes Mellitus in the Elderly Is Associated with Polypharmacy, Accompanied Comorbidities, and Various Increased Risks According to the Beers Criteria

Atak Tel,

Aktas,

Bilgin

et al. 2023

Diagnostics

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Comorbidity rates in the geriatric population have increased because of rising life expectancy; thus, patients have had to use more medications. Type 2 diabetes mellitus, one of the most common diseases, may influence the number of drugs used in geriatric patients. The present study was designed to investigate the association between the level of type 2 DM and polypharmacy. Fifty patients with type 2 diabetes over the age of 65 were included according to the inclusion criteria; 23 were well-controlled and 27 had poorly controlled diabetes. The groups were similar in terms of age, sex, WBC, Hb, Plt, AST, ALT, serum creatinine, fasting glucose, and eGFR levels. Patients with HbA1c values above 7.5 were classified as poorly controlled diabetes patients, and those below were considered well-controlled diabetes patients and were evaluated for inappropriate medication use. The number of medications used daily by the cases (p < 0.001), the number of concomitant diseases (p = 0.001), and the number of increased risks according to the Beers Criteria (p = 0.02) were observed to be high in poorly controlled type 2 diabetes mellitus subjects. HbA1c levels were related to the number of medications (r = 0.4, p = 0.004), comorbidities (r = 0.28, p = 0.04), and the number of increased risks according to the Beers Criteria (r = 0.31, p = 0.014). In conclusion, the number of medications used in patients with poorly controlled type 2 diabetes mellitus was found to be more elevated than in individuals with well-controlled type 2 diabetes mellitus. The HbA1c values varied among patients regarding polypharmacy, comorbidities, and increased risks according to the Beers Criteria.

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Effects of pharmacist intervention on polypharmacy in patients with type 2 diabetes in Japan

Cited by 4 publications

References 21 publications

Assessment of Polypharmacy among Diabetic Patients in Tertiary Care Hospital of Nepal

Assessment of Polypharmacy among Diabetic Patients in Tertiary Care Hospital of Nepal

Efficacy of a Pharmacist Team Clinical Medication Review in Older Adults: A Prospective and Retrospective Observational Study

Control Level of Type 2 Diabetes Mellitus in the Elderly Is Associated with Polypharmacy, Accompanied Comorbidities, and Various Increased Risks According to the Beers Criteria

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