Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research Institute and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.
Diabet Med. 2021 Apr;38(4):e14406. doi: 10.1111/dme.14406. Epub 2020 Oct 17.
To describe the prevalence and characteristics of polypharmacy in a Dutch cohort of individuals with type 2 diabetes.
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).
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.
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.
描述荷兰 2 型糖尿病队列中多重用药的流行情况和特征。
我们纳入了糖尿病珍珠队列中的 2 型糖尿病患者，其中 3886 例在初级保健中接受治疗，2873 例在学术保健（二级/三级）中接受治疗。通过对护理线进行多变量多项逻辑回归分析，我们评估了哪些社会人口统计学、生活方式和心血管代谢特征与中度（5-9 种药物）和重度多重用药（≥10 种药物）相关，与无多重用药（0-4 种药物）相比。
平均年龄为 63±10 岁，40%为女性。初级保健中每日药物的中位数为 5（IQR 3-7），学术保健中为 7（IQR 5-10）。初级保健中中度和重度多重用药的患病率分别为 44%和 10%，学术保健中分别为 53%和 29%。降血糖和调脂药物最为常见。重度多重用药者使用了相对大量的其他（即非心血管和非降血糖）药物。所有护理线的中度和重度多重用药均与年龄较大、教育程度较低、吸烟较多、糖尿病病程较长、BMI 较高和心血管疾病较多有关。
在初级保健中，超过一半的 2 型糖尿病患者存在严重和中度多重用药，在学术保健中更为常见。多重用药者的心血管代谢状况较差。这些结果强调了 2 型糖尿病中多重用药的重要性。
