MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Pediatrics Resident of Shahid Beheshti Hospital, Kashan University of Medical Sciences, Esfahan, Iran.
Arch Iran Med. 2021 Sep 1;24(9):657-664. doi: 10.34172/aim.2021.94.
Polypharmacy can negatively affect the life of type 2 diabetes (T2DM) patients. There is little evidence on the associated factors of, and patterns of polypharmacy among T2DM patients in developing regions. The aim of this study is to determine the population-based prevalence of polypharmacy, its associated factors, and pattern in southern Iran.
We used baseline data from the Pars Cohort Study (PCS). Age-standardized prevalence of polypharmacy and its 95% confidence interval (CI) were estimated. Association of polypharmacy with demographic and socio-economic factors, anthropometric measures, serum biomarkers, physical activity, cigarette and tobacco smoking, and multimorbidity was assessed by applying multivariable Poisson modeling. Prevalence ratio (PR) and its CI were estimated. The Anatomical Therapeutic Chemical (ATC) classification system was used for drug classification.
Totally, 874 previously diagnosed T2DM patients with a mean age of 56.3±9.2 participated in the study. The estimated age-standardized prevalence for men and women was 17.2% (CI: 12.0-22.0) and 34.1% (CI: 33.2-39.4), respectively. The prevalence of hypertension, hyperlipidemia and cardiovascular disorders among the study population was 39%, 58% and 20%, respectively. Having more than four comorbidities (PR, 3.90; CI, 2.39-6.34), central obesity (PR, 2.66; CI, 1.03-6.84), and female gender (PR, 1.49; CI, 1.14-1.97) were associated with polypharmacy. Also, 56.0% of patients and 23.0% of elder patients (>59 years old) reported using anti-diabetic agents.
Polypharmacy was low among T2DM patients. More than 75% of the elder population were not on anti-diabetic medications. Polypharmacy was higher among patients with multiple comorbidities, central obesity, lower physical activity, lower socio-economic status, younger age at diagnosis, and longer duration of T2DM.
药物的多重使用可能会对 2 型糖尿病（T2DM）患者的生活质量产生负面影响。在发展中地区，关于 T2DM 患者药物多重使用的相关因素和模式的证据很少。本研究的目的是确定伊朗南部 T2DM 患者药物多重使用的人群患病率、相关因素和模式。
我们使用 Pars 队列研究（PCS）的基线数据。估计了药物多重使用的年龄标准化患病率及其 95%置信区间（CI）。应用多变量泊松模型评估药物多重使用与人口统计学和社会经济因素、人体测量学指标、血清生物标志物、体力活动、香烟和烟草使用以及多种合并症之间的关联。估计了患病率比（PR）及其 CI。使用解剖治疗化学（ATC）分类系统进行药物分类。
总共纳入了 874 名先前诊断为 T2DM 的患者，平均年龄为 56.3±9.2 岁。估计男性和女性的年龄标准化患病率分别为 17.2%（CI：12.0-22.0）和 34.1%（CI：33.2-39.4）。研究人群中高血压、高血脂和心血管疾病的患病率分别为 39%、58%和 20%。患有四种以上合并症（PR，3.90；CI，2.39-6.34）、中心性肥胖（PR，2.66；CI，1.03-6.84）和女性（PR，1.49；CI，1.14-1.97）与药物多重使用相关。此外，56.0%的患者和 23.0%的老年患者（>59 岁）报告使用了降糖药物。
T2DM 患者的药物多重使用率较低。超过 75%的老年人群没有服用降糖药物。多重用药在患有多种合并症、中心性肥胖、体力活动较少、社会经济地位较低、诊断时年龄较小和 T2DM 病程较长的患者中更为常见。
