1. Introduction
Polypharmacy is the concurrent use of multiple medications and is
commonly defined as the chronic use of five or more medications daily
[1]. Older people are often seen as a high-risk group but
polypharmacy is not restricted to the age. Significant increases in
polypharmacy prevalence have also been observed in middle-aged people
[2-4]. With increasing polypharmacy, the risk of medication-related
harm increases. On the other hand, the use of multiple medications can
provide clinical benefit and may be needed, especially for people with
comorbidities [5,6]. Polypharmacy is common in people with diabetes,
and having diabetes is a risk factor for polypharmacy [7,8]. Many
diabetes patients are prescribed more than eight different drugs to
treat their diabetes and related diseases [5].
In general, polypharmacy is associated with more use of potentially
inappropriate medication (PIM) [9]. Not much is known about
polypharmacy in relation to PIM in people with diabetes. It seems that
PIM use is more common in older people with diabetes as compared to
younger people with diabetes or older people with hypertension
[10,11]. There is a worrying increase in the prevalence of diabetes
in younger age groups [12]. The extent of polypharmacy and PIM use
have not been investigated in detail in this age group. Better insights
into the trends of polypharmacy and PIM in older and middle-aged people
with diabetes are needed to guide the development of medication
optimization interventions.
The aim of our study was to assess (1) the trends in polypharmacy in
older and middle-aged people treated for diabetes, and (2) the trends of
PIM in those patients on polypharmacy.