Abstract
Polypharmacy (PP) occurs in patients with type 2 diabetes (T2DM) owing to multimorbidity. We evaluated concomitant PP and medication adherence in T2DM 3 years after initiation of administration of a hypoglycaemic agent using a nationwide claim-based database in Japan. Factors associated with medication PP and imperfect adherence were identified using multivariable logistic regression. PP was defined as using ≥6 medications. Patients with proportion of days covered (PDC) of <80% were defined as having poor medication adherence. A total of 884 patients were analysed. Multivariate analysis revealed that age, total number of consultations and body mass index (BMI) are factors that influence PP. Factors associated with PDC < 80% were 2–3, 4–5 and ≥ 6 medications compared with 1 medication, male sex, <17 consultations and age 50–59 and ≥ 60 years compared with <40 years. In conclusion, older age, high total number of consultations and BMI ≥ 25 kg/m2 are risk factors for PP. PP influenced good medication adherence at the end of the observation period.
Highlights
In Japan, the number of patients with diabetes is steadily increasing; the National Health and Nutrition Examination Survey Japan 2018 estimated that 10 million people had diabetes[1]
Adherence to hypoglycaemic medications is important for successful T2DM care and patient outcomes related to comorbidity management
A study conducted in the United States reported that medication adherence was low in asymptomatic patients with diabetes[8] and that 32% of patients with T2DM failed to continue treatment[9]
Summary
In Japan, the number of patients with diabetes is steadily increasing; the National Health and Nutrition Examination Survey Japan 2018 estimated that 10 million people had diabetes[1]. In a previous study in Japan, poor medication adherence was shown to increase the risk of diabetic microangiopathy[10].
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