Polypharmacy and comorbidity status in the treatment of type 2 diabetic patients attending a tertiary care hospital: An observational and questionnaire-based study

Abstract

Purpose/Aim:Diabetes mellitus is associated with several comorbid conditions. Thus, often, diabetic patients are prescribed multiple drugs. Although multiple drugs help to combat various diseases, they also increase the propensity of drug interactions and adverse drug reactions. The present study thus tried to evaluate the comorbid conditions and concurrent medications associated with type 2 diabetic patients. It also aimed to address patient compliance for the medications provided to them.Materials and Methods:This was a cross-sectional observational study conducted for 2 months – January–February 2017. Data were collected from prescriptions of the patients and also by interviewing the willing patients, attending the Diabetic Clinic of R. G. Kar Medical College, Kolkata, India.Results:During the study period, 150 patients were interviewed and their prescriptions were studied. Out of 150 patients, 69 (46%) were males and 81 (54%) were females. The mean age of the study population was 51.5 (±0.78) years. The present study evaluated that 83.3% (125) of the study population suffered from at least one comorbid conditions, the most common being hyperlipidemia (70.7%) and hypertension (47.3%). The average number of drugs prescribed is 4.72 (±0.11) per prescription. Metformin was prescribed to 96% of the patients. The concurrent medications recommended included hypolipidemics (72%), antihypertensives (68%), drugs for peptic ulcer (34.7%), and antiplatelets (10.7%).Conclusion:The present study thus concluded that diabetic patients suffer from a number of comorbid conditions, most commonly, cardiovascular problems. The comorbidity increased with the age. The level of polypharmacy was also high, thereby increasing the pill burden for the patients.

Prevalence and predictors of polypharmacy prescription among type 2 diabetes patients at a tertiary care department in Ningbo, China: A retrospective database study

“…In patients, it can adversely affect their adherence to medicines, quality of life and life expectancy, can lead to suboptimal blood glucose control and hospital admissions, and can increase severe hypoglycaemia risk and healthcare costs [10][11][12][13][14]. Studies conducted in different diabetes (including T2DM) populations and settings have reported a range of polypharmacy prevalence figures (6-85%) [15][16][17][18][19][20][21][22][23][24].…”

“…48% of patients with diabetes and hypertension in Canada were prescribed �9 medicines [19]. The average number of medicines prescribed to T2DM patients in India and Germany was five and 12, respectively [15,20]. A standardised universally accepted definition of polypharmacy is not available.…”

“…This study was conducted among T2DM patients who were discharged from the tertiary care department and thus, the generalisability of study findings is limited to similar populations and settings. As mentioned before, studies conducted in other diabetes (including T2DM) populations and settings have reported a range of prevalence figures [15][16][17][18][19][20][21]. In China, studies conducted in community settings have reported a much lower prevalence of polypharmacy (6-18%) [22][23][24].…”

Polypharmacy among people living with type 2 diabetes mellitus in rural communes in Vietnam

“…The requirement of additional medicine may also explain our results showing that the ORs of polypharmacy were associated with higher number of comorbidities, which is in line with recently published studies [ 15 , 21 , 43 – 45 ]. People with T2D are at high risk of arterial hypertension, cardiovascular disorder, hyperlipidemia, ect.,—all conditions, which require medicine: antihypertensive, antihyperlipidemic, antiplatelets medicines are often co-prescribed along with antidiabetic medicine [ 46 ].…”

Landscape of pharmacogenetic variants associated with non-insulin antidiabetic drugs in the Indian population

“…PPI-associated genes showed the maximum overlap (71%) with NIAD-associated genes followed by lipid-modifying/antiobesity drugs (38%), antihypertensives (25%) and antiarrhythmic/antiplatelet/anticoagulant agents (20%). This is highly relevant as the most coprescribed medications in Indian diabetes patients are hypolipidemics (72%), antihypertensives (68%), drugs for peptic ulcer (34.7%) and antiplatelets (10.7%) 35…”