Pros and cons of polypharmacy in elderly patients with diabetes

Wojtczak, Dominik; Kasznicki, Jacek; Drzewoski, Józef

doi:10.5603/dk.2017.0006

Cited by 8 publications

(6 citation statements)

References 20 publications

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“…Considering nancial point of view, it is important to monitor the prescriptions with polypharmacy using online monitoring platforms and references such as Beers criteria and Lexi-interact to minimize the unnecessary polypharmacy and enhance patients' quality of care in Iran [15,32,33].…”

Section: Resultsmentioning

confidence: 99%

Assessment of Cost and Diabetes Management Due to Polypharmacy in Iran Based on Haemoglobin A1c Levels, A Cross Sectional National Study

Daneshmand

Farzadfar

Jamshidi

et al. 2023

Preprint

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Background Patients with diabetes often receive multiple drug regimens termed ‘polypharmacy’. Since polypharmacy imposes excessive cost, we evaluated the prescriptions of patients with diabetes regarding polypharmacy, and its association with HbA1c levels and cost. Method 102 million prescriptions of Iranian health insurance data in 2015 and 2016 were overlapped with STEPS Iran 2016 survey database. Then, 2075 Metabolic syndrome patients were selected. Among the patients who consumed anti diabetes medications; individual and sociodemographic factors, and polypharmacy were assessed and association between these factors and HbA1c levels were quantified using logistic regression. Each patient’s prescription costs in 2015 and 2016 and its association with individual and sociodemographic factors as well as polypharmacy was assessed using linear regression. Results Out of 2075 metabolic syndrome patients, 205 patients had diabetes according to their fasting blood glucose in 2015 and 2016. HbA1c was significantly more controlled (≤7%) in urban areas. No significant association existed between polypharmacy and HbA1c levels. Medication cost was significantly higher in male patients, patients above 80 years, and patients with >12 years of education (p< 0.05). Area of living and wealth index had no significant association with cost. Conclusion Although diabetic patients with polypharmacy significantly pay more money for their prescriptions, no significant difference was observed between their HbA1c levels.

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Section: Resultsmentioning

confidence: 99%

Assessment of Cost and Diabetes Management Due to Polypharmacy in Iran Based on Haemoglobin A1c Levels, A Cross Sectional National Study

Daneshmand

Farzadfar

Jamshidi

et al. 2023

Preprint

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“…Целевых уровней АД достигает лишь 1/3 пациентов, получающих один АГП [12], а снижение уровня АД в 5 раз ниже по сравнению с комбинированной терапией из двух препаратов разных классов [10]. В исследовании ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) ~90% пациентов с АГ нуждались в назначении не <2 АГП для достижения целевых уровней АД [13]. В исследовании STITCH (Simplified Treatment Intervention to Control Hypertension) назначение комбинации ингибитора ангиотензинпревращающего фермента (иАПФ) и диуретика обеспечило лучший контроль за уровнем АД по сравнению с постепенной титрацией дозы одного АГП в течение 6 мес.…”

Section: результатыunclassified

Effective therapy of hypertension from the standpoint of patient-centered medicine

Podzolkov,

Vetluzhskaya,

Bragina

et al. 2023

Cardiovasc Ther Prev

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The article presents current data on the choice of antihypertensives from the standpoint of patient-centered medicine. The advantages of combined initial therapy includes high medical adherence, achievement of target blood pressure, and organ protection. Data on the effectiveness of a fixed-dose combination of an angiotensin-converting enzyme inhibitor and a thiazide-like diuretic, in particular, the most commonly used angiotensin-converting enzyme inhibitor lisinopril and long-acting indapamide, are presented. This combination is not only highly effective, but also metabolically neutral, which allows it to be used in patients with obesity, diabetes, and liver diseases. Data are presented on the new favorable effects of lisinopril and indapamide, in particular, on the effect of indapamide on the intestinal microbiota. The potential advantages of this combination as an initial therapy for hypertension in Russian patients are described.

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“…Polypharmacy has been shown to be more effective than monotherapy in the treatment of a variety of diseases, including arterial hypertension. For example, approximately 90% of hypertension patients in the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) required at least two antihypertensive medicines to attain blood pressure targets [ 8 ]. The additional antihypertensive benefit of combining medications from two distinct classes is almost five times stronger than doubling the dose of a single agent, according to a meta-analysis of 42 studies involving nearly 11,000 hypertensive patients [ 41 ].…”

Section: Hypertension Treatmentmentioning

confidence: 99%

“…Unfortunately, combination medicines are frequently employed without scientific backing [ 6 ]. The benefit of polypharmacy versus monotherapy has been demonstrated in a number of well-known disease types, including cardiovascular disease [ 7 ], diabetes [ 8 ], as well as chronic pain [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Single-Pill Combination to Improve Hypertension Treatment: Pharmaceutical Industry Development

Paczkowska-Walendowska

Sip

Staszewski

et al. 2022

IJERPH

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Multiple illness is an increasingly common phenomenon. Its consequence is the need for polytherapy, which is particularly common among people suffering from arterial hypertension. The development of combined preparations (containing at least two API-active pharmaceutical ingredients) dedicated to the treatment of hypertension is a response to increased compliance, especially in elderly patients. In our work, we describe in particular the possibilities of using β-adrenergic receptors blockers and angiotensin-converting enzyme inhibitors in combinations. The combinations of APIs are used as single pills in patients with arterial hypertension with concomitant diseases such as hyperlipidemia; blood coagulation problems and diabetes mellitus were also discussed successively. Pharmacoeconomic analysis for the API combinations shown is also presented. As a final conclusion, numerous benefits of using the combined preparations should be indicated, especially by the elderly and/or in patients with coexistence of other diseases.

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Pros and cons of polypharmacy in elderly patients with diabetes

Abstract: ABSTRACT

Cited by 8 publications

References 20 publications

Assessment of Cost and Diabetes Management Due to Polypharmacy in Iran Based on Haemoglobin A1c Levels, A Cross Sectional National Study

Assessment of Cost and Diabetes Management Due to Polypharmacy in Iran Based on Haemoglobin A1c Levels, A Cross Sectional National Study

Effective therapy of hypertension from the standpoint of patient-centered medicine

Single-Pill Combination to Improve Hypertension Treatment: Pharmaceutical Industry Development

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