Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
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
MEDLINE
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.