Sex-specific medication trajectories in older adults newly diagnosed with diabetes
Background: People with diabetes tend to use many medications to treat diabetes and comorbidities. Nevertheless, the evolution of polypharmacy in newly diagnosed males and females has been little studied. Objective: The objective of this paper was to identify and describe medication trajectories in...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Exploratory Research in Clinical and Social Pharmacy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667276623000756 |
| _version_ | 1827793908700020736 |
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| author | Miceline Mésidor Denis Talbot Marc Simard Claudia Blais Véronique Boiteau Caroline Sirois |
| author_facet | Miceline Mésidor Denis Talbot Marc Simard Claudia Blais Véronique Boiteau Caroline Sirois |
| author_sort | Miceline Mésidor |
| collection | DOAJ |
| description | Background: People with diabetes tend to use many medications to treat diabetes and comorbidities. Nevertheless, the evolution of polypharmacy in newly diagnosed males and females has been little studied. Objective: The objective of this paper was to identify and describe medication trajectories in incident diabetes cases according to sex. Methods: Data were obtained from the Quebec Integrated Chronic Disease Surveillance System. We built a population-based cohort of community-dwelling individuals aged >65 years diagnosed with diabetes in 2014 who were alive and covered with the public drug plan until March 31, 2019. Latent class models were used to identify medication trajectory groups in males and females separately. Results: Of the 10,363 included individuals, 51.4% were males. Females were older and more likely to have more medication claims than males. Four trajectory groups were identified for males and five for females. Most trajectories showed sustained and stable number of medications over time. For each sex, only one of the trajectory groups included a mean annual number of medications lesser than five. Slight increasing trends of medication use were detected in the trajectories composed of very high users, which included older, more comorbid individuals frequently exposed to potentially inappropriate medications. Conclusions: Most males and females with incident diabetes had a high burden of medication following the year of diagnosis and were classified in a group of sustained medication use over time. The largest increase in medication was among those who had higher level of polypharmacy of questionable quality at baseline, raising concerns about the innocuity of such medication trajectories. |
| first_indexed | 2024-03-11T18:25:18Z |
| format | Article |
| id | doaj.art-b0d15b67b751496c994aa52312f0b6c5 |
| institution | Directory Open Access Journal |
| issn | 2667-2766 |
| language | English |
| last_indexed | 2024-03-11T18:25:18Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj.art-b0d15b67b751496c994aa52312f0b6c52023-10-14T04:45:44ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662023-09-0111100294Sex-specific medication trajectories in older adults newly diagnosed with diabetesMiceline Mésidor0Denis Talbot1Marc Simard2Claudia Blais3Véronique Boiteau4Caroline Sirois5Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand-Vandry 1050, Avenue de la Médecine, Québec G1V 0A6, Canada; Centre de Recherche du CHU de Québec – Université Laval, 2400 Av. D'Estimauville, Québec G1E 6W2, Canada; Corresponding author at: Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada.Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand-Vandry 1050, Avenue de la Médecine, Québec G1V 0A6, Canada; Centre de Recherche du CHU de Québec – Université Laval, 2400 Av. D'Estimauville, Québec G1E 6W2, CanadaDépartement de médecine sociale et préventive, Université Laval, Pavillon Ferdinand-Vandry 1050, Avenue de la Médecine, Québec G1V 0A6, Canada; Institut National de Santé Publique du Québec, 945, av Wolfe, Québec G1V 5B3, CanadaFaculté de Pharmacie, Université Laval, Pavillon Ferdinand-Vandry, 1050 Av. de la Médecine, Québec G1V 0A6, Canada; Institut National de Santé Publique du Québec, 945, av Wolfe, Québec G1V 5B3, CanadaInstitut National de Santé Publique du Québec, 945, av Wolfe, Québec G1V 5B3, CanadaCentre de Recherche du CHU de Québec – Université Laval, 2400 Av. D'Estimauville, Québec G1E 6W2, Canada; Faculté de Pharmacie, Université Laval, Pavillon Ferdinand-Vandry, 1050 Av. de la Médecine, Québec G1V 0A6, Canada; Institut National de Santé Publique du Québec, 945, av Wolfe, Québec G1V 5B3, CanadaBackground: People with diabetes tend to use many medications to treat diabetes and comorbidities. Nevertheless, the evolution of polypharmacy in newly diagnosed males and females has been little studied. Objective: The objective of this paper was to identify and describe medication trajectories in incident diabetes cases according to sex. Methods: Data were obtained from the Quebec Integrated Chronic Disease Surveillance System. We built a population-based cohort of community-dwelling individuals aged >65 years diagnosed with diabetes in 2014 who were alive and covered with the public drug plan until March 31, 2019. Latent class models were used to identify medication trajectory groups in males and females separately. Results: Of the 10,363 included individuals, 51.4% were males. Females were older and more likely to have more medication claims than males. Four trajectory groups were identified for males and five for females. Most trajectories showed sustained and stable number of medications over time. For each sex, only one of the trajectory groups included a mean annual number of medications lesser than five. Slight increasing trends of medication use were detected in the trajectories composed of very high users, which included older, more comorbid individuals frequently exposed to potentially inappropriate medications. Conclusions: Most males and females with incident diabetes had a high burden of medication following the year of diagnosis and were classified in a group of sustained medication use over time. The largest increase in medication was among those who had higher level of polypharmacy of questionable quality at baseline, raising concerns about the innocuity of such medication trajectories.http://www.sciencedirect.com/science/article/pii/S2667276623000756DiabetesMedication useOlder adultsSex differencesLatent class modelsQuebec |
| spellingShingle | Miceline Mésidor Denis Talbot Marc Simard Claudia Blais Véronique Boiteau Caroline Sirois Sex-specific medication trajectories in older adults newly diagnosed with diabetes Exploratory Research in Clinical and Social Pharmacy Diabetes Medication use Older adults Sex differences Latent class models Quebec |
| title | Sex-specific medication trajectories in older adults newly diagnosed with diabetes |
| title_full | Sex-specific medication trajectories in older adults newly diagnosed with diabetes |
| title_fullStr | Sex-specific medication trajectories in older adults newly diagnosed with diabetes |
| title_full_unstemmed | Sex-specific medication trajectories in older adults newly diagnosed with diabetes |
| title_short | Sex-specific medication trajectories in older adults newly diagnosed with diabetes |
| title_sort | sex specific medication trajectories in older adults newly diagnosed with diabetes |
| topic | Diabetes Medication use Older adults Sex differences Latent class models Quebec |
| url | http://www.sciencedirect.com/science/article/pii/S2667276623000756 |
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