Details

Autor(en) / Beteiligte

• AL-Musawe, Labib
• Torre, Carla
• Guerreiro, Jose Pedro
• Rodrigues, Antonio Teixeira
• Raposo, Joao Filipe
• Mota-Filipe, Helder
• Martins, Ana Paula

Titel

Drug-drug interactions and inappropriate medicines impact on glycemic control and kidney function in older adults with diabetes-attending specialty care institution

Ist Teil von

• European journal of clinical pharmacology, 2021-09, Vol.77 (9), p.1397-1407

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2021

Quelle

SpringerLink

Beschreibungen/Notizen

• Purpose To describe and assess the impact of polypharmacy, and its potential adverse reactions; serious clinically relevant drug-drug interactions (DDIs) and inappropriate medicines (PIMs) on glycemic target, and kidney function in a sample of older adults with type 2 diabetes (T2D). Methods Cross-sectional study was performed in a real-world database including 444 elderly people with T2D from the Portuguese Diabetes Association, aged ≥ 65 years, and registered in 2018. DDIs were analyzed using Micromedex drug-interaction platform and PIMs identified using STOPP criteria version-2. Results Polypharmacy was identified in 43.6% of patients. This group of patients has shown to be more females (50 vs. 39.6%, P =0.0208), higher HbA1c targets ( P =0.0275), longer diabetes duration (66.4 vs. 54.4%, P =0.0019), more hypertensive (87 vs. 62.9%, P <0.0001), using more insulin (38.1 vs. 26%, P =0.0062), sulfonylureas (37.1 vs. 15.6%, P <0.0001), GLP-1 receptor-agonists (9.7 vs. 3.6%, P =0.0077), metformin-DPP-4 inhibitors (41.2 vs. 29.2%, P =0.0081), and SGLT2 inhibitors (19 vs. 9.6%, P =0.0040). A total of 8.7% of patients had potentially serious clinically relevant DDIs, mainly due to interacting medicine pairs dexamethasone and fluoroquinolones. Furthermore, 23.4% had PIMs, and cardiovascular medicines accounted for largest therapeutic group associated. Polypharmacy found to be associated with twofold greater odds of having HbA1c ≤8%, whereas PIMs associated with 2.5-fold greater odds of having HbA1c ≤9%, and 5.5-folds greater odds of having severe kidney function. Conclusions These findings suggested that there is a potential association between polypharmacy and PIMs and altered glycemic control, and PIMs with the deterioration of kidney function.