Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes
Aim: This study aimed to identify the association of chronic polypharmacy and potentially inappropriate medications (PIMs) with adverse health outcomes (AHOs) in community-dwelling older adults with diabetes in China.Methods: A 2-year retrospective cohort study was conducted using 11,829 community-f...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1284287/full |
| _version_ | 1797626717265723392 |
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| author | Lvliang Lu Shuang Wang Jiaqi Chen Yujie Yang Kai Wang Jing Zheng Pi Guo Yunpeng Cai Qingying Zhang |
| author_facet | Lvliang Lu Shuang Wang Jiaqi Chen Yujie Yang Kai Wang Jing Zheng Pi Guo Yunpeng Cai Qingying Zhang |
| author_sort | Lvliang Lu |
| collection | DOAJ |
| description | Aim: This study aimed to identify the association of chronic polypharmacy and potentially inappropriate medications (PIMs) with adverse health outcomes (AHOs) in community-dwelling older adults with diabetes in China.Methods: A 2-year retrospective cohort study was conducted using 11,829 community-followed older adults with diabetes and medical records from 83 hospitals and 702 primary care centers in Shenzhen, China. Chronic polypharmacy and PIMs were identified from prescription records using Beers’ criteria, and their associated AHO was analyzed using multivariable logistic regression analysis.Results: The prevalence of chronic polypharmacy and at least one PIM exposure was 46.37% and 55.09%, respectively. The top five PIMs were diuretics, benzodiazepines, first-generation antihistamines, sulfonylureas, and insulin (sliding scale). Chronic polypharmacy was positively associated with all-cause hospital admission, admission for coronary heart disease, admission for stroke, admission for dementia, and emergency department visits. Exposure to PIMs was positively associated with all-cause hospital admission, admission for heart failure (PIMs ≥2), admission for stroke (PIMs ≥3), emergency department visits, bone fracture, constipation, and diarrhea.Conclusion: Chronic polypharmacy and PIMs were prevalent in older adults with diabetes in Chinese communities. Iatrogenic exposure to chronic polypharmacy and PIMs is associated with a higher incidence of different AHOs. This observational evidence highlights the necessity of patient-centered medication reviews for chronic polypharmacy and PIMs use in older patients with diabetes in primary care facilities in China and draws attention to the caution of polypharmacy, especially PIM use in older adults with diabetes in clinical practice. |
| first_indexed | 2024-03-11T10:14:10Z |
| format | Article |
| id | doaj.art-d285f54002ac48c3ab55188c86e146f7 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-11T10:14:10Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-d285f54002ac48c3ab55188c86e146f72023-11-16T12:43:29ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-11-011410.3389/fphar.2023.12842871284287Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetesLvliang Lu0Shuang Wang1Jiaqi Chen2Yujie Yang3Kai Wang4Jing Zheng5Pi Guo6Yunpeng Cai7Qingying Zhang8Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, ChinaShenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, ChinaDepartment of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, ChinaShenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, ChinaDepartment of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, ChinaShenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, ChinaDepartment of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, ChinaShenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, ChinaDepartment of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, ChinaAim: This study aimed to identify the association of chronic polypharmacy and potentially inappropriate medications (PIMs) with adverse health outcomes (AHOs) in community-dwelling older adults with diabetes in China.Methods: A 2-year retrospective cohort study was conducted using 11,829 community-followed older adults with diabetes and medical records from 83 hospitals and 702 primary care centers in Shenzhen, China. Chronic polypharmacy and PIMs were identified from prescription records using Beers’ criteria, and their associated AHO was analyzed using multivariable logistic regression analysis.Results: The prevalence of chronic polypharmacy and at least one PIM exposure was 46.37% and 55.09%, respectively. The top five PIMs were diuretics, benzodiazepines, first-generation antihistamines, sulfonylureas, and insulin (sliding scale). Chronic polypharmacy was positively associated with all-cause hospital admission, admission for coronary heart disease, admission for stroke, admission for dementia, and emergency department visits. Exposure to PIMs was positively associated with all-cause hospital admission, admission for heart failure (PIMs ≥2), admission for stroke (PIMs ≥3), emergency department visits, bone fracture, constipation, and diarrhea.Conclusion: Chronic polypharmacy and PIMs were prevalent in older adults with diabetes in Chinese communities. Iatrogenic exposure to chronic polypharmacy and PIMs is associated with a higher incidence of different AHOs. This observational evidence highlights the necessity of patient-centered medication reviews for chronic polypharmacy and PIMs use in older patients with diabetes in primary care facilities in China and draws attention to the caution of polypharmacy, especially PIM use in older adults with diabetes in clinical practice.https://www.frontiersin.org/articles/10.3389/fphar.2023.1284287/fullpolypharmacypotentially inappropriate medicationsadverse health outcomeolderdiabetesclinical practice |
| spellingShingle | Lvliang Lu Shuang Wang Jiaqi Chen Yujie Yang Kai Wang Jing Zheng Pi Guo Yunpeng Cai Qingying Zhang Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes Frontiers in Pharmacology polypharmacy potentially inappropriate medications adverse health outcome older diabetes clinical practice |
| title | Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes |
| title_full | Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes |
| title_fullStr | Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes |
| title_full_unstemmed | Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes |
| title_short | Associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community-dwelling older adults with diabetes |
| title_sort | associated adverse health outcomes of polypharmacy and potentially inappropriate medications in community dwelling older adults with diabetes |
| topic | polypharmacy potentially inappropriate medications adverse health outcome older diabetes clinical practice |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1284287/full |
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