Polypragmasy and the basics of personalized rational pharmacotherapy selection in older patients with obesity and type 2 diabetes mellitus

Increasing life expectancy and, as a consequence, a large number of comorbidities lead to a multitude of medications prescribed by physicians of different specialties. Patients with obesity and carbohydrate metabolism disorders, especially with type 2 diabetes mellitus (DM2), are at particular risk of polypragmasy, which is associated with the use of potentially nonrecommended medications. Prescribing errors can cause significant harm to the patient’s health and increase the risk of rehospitalization and healthcare costs. Identification of probably not recommended drugs in this category of patients will improve understanding of prevalence and risk factors of their use, develop strategies to prevent and limit the burden of taking inappropriate drugs and promote development of personalized and patient-oriented treatment options. Tools exist to assess potentially inappropriate therapy (PIT) in the elderly and new tools and criteria are often created. However, they are not specifically aimed at people with obesity and carbohydrate metabolism disorders. Thus, these criteria usually include only a few items related to DM2. Consequently, there is a clear need for a modern tool that can be used to address PIT specifically in older adults with obesity and carbohydrate metabolism disorders.