Prevalence and predictors of polypharmacy prescription among type 2 diabetes patients at a tertiary care department in Ningbo, China: A retrospective database study

Abstract

Objectives: To determine the prevalence of polypharmacy prescription among type 2 diabetes (T2DM) patients at a tertiary care department in Ningbo, China, and to determine factors that independently predict this polypharmacy prescription.

Methods: A retrospective cross-sectional study was conducted using an existing computerised medical records database. This database was screened from 2012 to 2017 for adult patients with T2DM and parameters like prescribed medicines and socio-demographic, behavioural and other medical information. Polypharmacy prescription was defined as the simultaneous prescription of ≥5 medicines by the clinician at the time of discharge for daily usage by the patient as part of his/her long-term treatment plan.

Results: The study inclusion criteria were satisfied by 3370 T2DM patients. Over a 5-year period, 72.2% (n = 2432) of T2DM patients were prescribed polypharmacy. On an average, eight medicines were prescribed to them. The odds of polypharmacy prescription increased with patients' age (18-39 years: 1; 40-59 years: OR 1.86, 95% CI 1.28-2.71; and ≥60 years: 2.42, 1.65-3.55), duration of T2DM (≤1 year: 1; >5-10 years: 1.70, 1.10-2.62; and >10 years: 2.55, 1.68-3.89), and length of hospital stay (≤5 days: 1; >5-10 days: 2.43, 1.86-3.17; and >10 days: 2.99, 2.24-3.99), and were higher in those with poor blood glucose level (2.09, 1.67-2.62) and with comorbidities like other endocrine, nutritional and metabolic diseases (2.24, 1.76-2.85), circulatory system diseases (4.35, 3.62-5.23), skin and subcutaneous tissue diseases (1.64, 1.04-2.59), and musculoskeletal system and connective tissue diseases (1.61, 1.27-2.03). The odds of polypharmacy prescription were lower in those with comorbidities like neoplasms (0.51, 0.36-0.70) and during pregnancy, childbirth and the puerperium (0.06, 0.01-0.49).

Conclusions: Around three fourth of T2DM patients at the tertiary care department were prescribed polypharmacy, and the predictors were identified. The study findings could be taken into consideration in future interventional studies aimed at supporting medicines optimisation (and deprescribing) among these patients.

Fig 1. Number of prescribed medicines in our study.