Characteristics associated with polypharmacy in people with type 2 diabetes: the Dutch Diabetes Pearl cohort

S. van Oort*, F. Rutters, the Diabetes Pearl from the Parelsnoer Initiative, M. F. Warlé-van Herwaarden, M. T. Schram, C. D. Stehouwer, C. J. Tack, E. J. Abbink, B. H. Wolffenbuttel, M. M. van der Klauw, J. H. DeVries, S. E. Siegelaar, E. J. Sijbrands, B. Özcan, H. W. de Valk, B. Silvius, M. A. Schroijen, I. M. Jazet, A. J. van Ballegooijen, J. W.J. BeulensP. J. Elders, C. Kramers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Aim: To describe the prevalence and characteristics of polypharmacy in a Dutch cohort of individuals with type 2 diabetes. Methods: We included people with type 2 diabetes from the Diabetes Pearl cohort, of whom 3886 were treated in primary care and 2873 in academic care (secondary/tertiary). With multivariable multinomial logistic regression analyses stratified for line of care, we assessed which sociodemographic, lifestyle and cardiometabolic characteristics were associated with moderate (5–9 medications) and severe polypharmacy (≥10 medications) compared with no polypharmacy (0–4 medications). Results: Mean age was 63 ± 10 years, and 40% were women. The median number of daily medications was 5 (IQR 3–7) in primary care and 7 (IQR 5–10) in academic care. The prevalence of moderate and severe polypharmacy was 44% and 10% in primary care, and 53% and 29% in academic care respectively. Glucose-lowering and lipid-modifying medications were most prevalent. People with severe polypharmacy used a relatively large amount of other (i.e. non-cardiovascular and non-glucose-lowering) medication. Moderate and severe polypharmacy across all lines of care were associated with higher age, low educational level, more smoking, longer diabetes duration, higher BMI and more cardiovascular disease. Conclusions: Severe and moderate polypharmacy are prevalent in over half of people with type 2 diabetes in primary care, and even more in academic care. People with polypharmacy are characterized by poorer cardiometabolic status. These results highlight the significance of polypharmacy in type 2 diabetes.

Original languageEnglish
Article numbere14406
JournalDiabetic Medicine
Issue number4
Publication statusPublished - Apr 2021

Bibliographical note

Funding Information:
The initial organization of the Dutch Diabetes Pearl was co‐financed by the Dutch Government and the eight Dutch University Medical Centers. The continuation is financed by the Dutch Federation of University Medical Centers. The funding body had no role in designing the study or in collecting, analysing, or interpreting data.

Publisher Copyright: © 2020 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK


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