Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam.
Department of Embryology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam.
PLoS One. 2021 Apr 8;16(4):e0249849. doi: 10.1371/journal.pone.0249849. eCollection 2021.
People with diabetes are at high risk of polypharmacy owing to complex treatment of diabetes and comorbidities. Polypharmacy is associated with increased risk of adverse reactions and decreased compliance. Therefore, the objectives of this study were to assess polypharmacy in people with type 2 diabetes (T2D) and associated diabetes-related factors in rural areas in Vietnam.
People with T2D (n = 806) who had received treatment for diabetes at a district hospital were invited to participate in a questionnaire-based cross-sectional survey. Polypharmacy was defined as ≥5 types of medicine and assessed as a) prescription medicine and non-prescription/over the counter (OTC) medicine and b) prescription medicine and non-prescription/OTC, herbal and traditional medicine, and dietary supplement. Multiple logistic regression was used to investigate the association between polypharmacy and diabetes specific factors: duration, comorbidities and diabetes-related distress.
Of the people with T2D, 7.8% had a medicine use corresponding to polypharmacy (prescription medicine and non-prescription/OTC), and 40.8% when herbal and traditional medicine, and dietary supplement were included. Mean number of medicine intake (all types of medicines and supplements) were 3.8±1.5. The odd ratios (ORs) of polypharmacy (medicine and supplements) increased with diabetes duration (<1-5 years OR = 1.66; 95%CI: 1.09-2.53 and >5 years OR = 1.74; 95%CI: 1.14-2.64 as compared to ≤1-year duration of diabetes), number of comorbidities (1-2 comorbidities: OR = 2.0; 95%CI: 1.18-3.42; ≥3 comorbidities: OR = 2.63;95%CI: 1.50-4.61 as compared to no comorbidities), and suffering from diabetes-related distress (OR = 1.49; 95%CI: 1.11-2.01) as compared to those without distress.
In rural northern Vietnam, persons with longer duration of T2D, higher number of comorbidities and diabetes-related stress have higher odds of having a medicine use corresponding to polypharmacy. A high proportion of people with T2D supplement their prescription, non-prescription/OTC medicine with herbal and traditional medicine and dietary supplements.
由于糖尿病的复杂治疗和合并症，糖尿病患者有很高的多药治疗风险。多药治疗与不良反应风险增加和依从性降低有关。因此，本研究的目的是评估越南农村地区 2 型糖尿病（T2D）患者的多药治疗情况及相关糖尿病相关因素。
邀请在区医院接受糖尿病治疗的 806 名 T2D 患者参加一项基于问卷的横断面调查。多药治疗定义为≥5 种药物，并评估为 a）处方药和非处方药/非处方（OTC）药物和 b）处方药和非处方药/OTC、草药和传统药物以及膳食补充剂。采用多因素逻辑回归分析多药治疗与糖尿病特定因素的关系：病程、合并症和糖尿病相关困扰。
在 T2D 患者中，有 7.8%的人使用的药物符合多药治疗标准（处方药和非处方药/OTC），而包括草药和传统药物以及膳食补充剂在内的患者比例为 40.8%。服用的药物种类（所有类型的药物和补充剂）的平均值为 3.8±1.5。多药治疗（药物和补充剂）的比值比（OR）随着糖尿病病程的增加而增加（<1-5 年 OR=1.66；95%CI：1.09-2.53 和>5 年 OR=1.74；95%CI：1.14-2.64 与糖尿病病程≤1 年相比）、合并症数量（1-2 种合并症：OR=2.0；95%CI：1.18-3.42；≥3 种合并症：OR=2.63；95%CI：1.50-4.61 与无合并症相比）和患有糖尿病相关困扰（OR=1.49；95%CI：1.11-2.01）相比，无困扰的患者。
在越南北部农村地区，T2D 病程较长、合并症较多、糖尿病相关压力较大的患者多药治疗的可能性更高。相当一部分 T2D 患者在使用处方药物、非处方/OTC 药物的同时，还会使用草药和传统药物以及膳食补充剂。
