Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Department of Diabetes, Endocrinology and Metabolism, Gifu University Graduate School of Medicine, Gifu, Japan.
J Diabetes Investig. 2023 Oct;14(10):1202-1208. doi: 10.1111/jdi.14046. Epub 2023 Jun 25.
AIMS/INTRODUCTION: Polypharmacy in diabetes patients is related to worse clinical outcomes. The aim of this study was to evaluate the usefulness of our countermeasure for polypharmacy, which combines a pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy.
A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included diabetic patients taking six or more drugs on admission to the diabetes ward between July 2021 and June 2022. Drugs which were discontinued by the present countermeasure were examined, and the number of drugs being taken by each patient was compared between admission and discharge.
102 of 308 patients were taking six or more drugs on admission. The drugs being taken by these patients were evaluated by pharmacists using a checklist for polypharmacy. Eighty-four drugs which were evaluated as inappropriate or potentially inappropriate medications by pharmacists were discontinued following the multidisciplinary team review. The median and mean number of drugs taken by the 102 patients significantly decreased from 9.0 (IQR: 8-12) and 9.26 ± 2.64 on admission to 9.0 (IQR: 6-10) and 8.42 ± 2.95 on discharge (P = 0.0002). We followed up with these patients after discontinuation of the drugs and confirmed that their clinical status had not deteriorated.
The present countermeasure for polypharmacy, which combines a pharmacist check based on a checklist for evaluating polypharmacy followed by a multidisciplinary team review, was useful for reducing the number of inappropriate or potentially inappropriate medications taken by diabetes patients with polypharmacy.
目的/引言：糖尿病患者的多种药物治疗与较差的临床结局有关。本研究旨在评估我们针对多种药物治疗的对策的有效性，该对策结合了药剂师检查，随后由多学科团队对多种药物治疗的糖尿病患者进行审查。
在岐阜大学医院进行了一项单中心、回顾性观察研究。研究参与者包括 2021 年 7 月至 2022 年 6 月期间在糖尿病病房入院时服用六种或更多药物的糖尿病患者。检查了通过本对策停用的药物，并比较了每位患者入院和出院时服用的药物数量。
102 例 308 例患者入院时服用六种或更多药物。这些患者的药物由药剂师使用药物治疗检查表进行评估。药剂师评估为不适当或潜在不适当的药物后，经多学科团队审查，停用了 84 种药物。102 例患者的药物中位数和平均值从入院时的 9.0（IQR：8-12）和 9.26±2.64 显著减少至出院时的 9.0（IQR：6-10）和 8.42±2.95（P=0.0002）。我们在停药后对这些患者进行了随访，确认他们的临床状况没有恶化。
本研究中针对多种药物治疗的对策，结合了基于评估药物治疗检查表的药剂师检查，随后由多学科团队进行审查，对于减少多种药物治疗的糖尿病患者服用的不适当或潜在不适当药物的数量是有效的。
