Fatma Tuğçe Şah Ünal, Asena Gökçay Canpolat, Rıfat Emral, Cem Haymana, İbrahim Demirci, Serpil Salman, Canan Ersoy, Fahri Bayram, İlhan Satman, Alper Sönmez, Demet Çorapçıoğlu, Temd-Study Group
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引用次数: 0
Abstract
Background: Polypharmacy is a growing concern in the management of patients with Type 2 diabetes mellitus (T2DM), as multiple comorbidities necessitate complex pharmacological regimens. However, excessive medication use has been associated with adverse drug reactions, medication non-adherence, and poor clinical outcomes. Understanding the impact of polypharmacy in patients with T2DM is essential for optimizing treatment strategies.
Methods: This nationwide, cross-sectional study analyzed data from a 2023 survey involving 4,956 patients with T2DM across Türkiye. Polypharmacy was defined as the use of five or more medications. Demographic characteristics, comorbidities, diabetes-related complications, and laboratory parameters were compared between patients using 1-4 medications and those with polypharmacy. Logistic regression analysis identified independent predictors of polypharmacy.
Results: Polypharmacy was observed in 46.7% (n = 2,312) of the patients. Those with polypharmacy were significantly older, had a longer diabetes duration, higher body mass index, and elevated systolic blood pressure (p < 0.001). The prevalence of macrovascular and microvascular complications was higher in this group (p < 0.001), and severe hypoglycemia was more frequent (p = 0.034). Regression analysis identified older age, longer diabetes duration, dyslipidemia, hypertension, nonalcoholic fatty liver disease, hypothyroidism, osteoporosis, coronary artery disease, cerebrovascular disease, neuropathy, and nephropathy as factors independently associated with polypharmacy (p < 0.001).
Conclusion: Polypharmacy is highly prevalent in older adults with T2DM and is associated with an increased burden of complications. These findings highlight the importance of careful medication assessment in patients with T2DM with complex comorbidity profiles.
Clinical trial registration: www.clinicaltrials.gov identifier is NCT06347445.
背景：在2型糖尿病（T2DM）患者的治疗中，多种药物治疗越来越受到关注，因为多种合并症需要复杂的药物治疗方案。然而，过度用药与药物不良反应、药物不依从性和不良临床结果有关。了解多重用药对T2DM患者的影响对于优化治疗策略至关重要。方法：这项全国性的横断面研究分析了来自2023年一项调查的数据，该调查涉及全国4,956名T2DM患者。多药被定义为使用五种或更多药物。比较1-4种药物治疗组和多种药物治疗组的人口学特征、合并症、糖尿病相关并发症和实验室参数。Logistic回归分析确定了多药的独立预测因素。结果：46.7% （n = 2312）的患者存在多药现象。多药组患者年龄较大，糖尿病病程较长，体重指数较高，收缩压升高（p p p = 0.034）。回归分析发现，年龄较大、糖尿病病程较长、血脂异常、高血压、非酒精性脂肪性肝病、甲状腺功能减退、骨质疏松、冠状动脉疾病、脑血管疾病、神经病变和肾病是与多重用药独立相关的因素(p结论：多重用药在老年T2DM患者中非常普遍，并与并发症负担增加有关。这些发现强调了对具有复杂合并症的2型糖尿病患者进行仔细用药评估的重要性。临床试验注册：www.clinicaltrials.gov标识符：NCT06347445。
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