Abstract
Aim: To summarize the existing literature concerning the association between polypharmacy and adverse health consequences in elderly patients with type 2 diabetes mellitus. Methods: We searched four literature databases (PubMed/Medline, ScienceDirect and Web of Science) through April 2019. We included all studies that addressed the association between polypharmacy and all-cause of mortality, glycemic control, macrovacular complications, hospitalization, potentially inappropriate medicines, drug-drug interactions and fall. A statistical program OpenMeta [Analyst] was used. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random effects model. I2 statistics was performed to assess heterogeneity. Results: Out of sixteen studies, three studies were used for meta-analysis. A statistically significant association was found between polypharmacy and all-cause mortality (OR = 1.622, 95% CI (1.606–1.637) P < 0.001), and myocardial infarction (OR = 1.962, 95% CI (1.942–1.982), P < 0.001. Non-statistically significant association with evidence of moderate heterogeneity was found between polypharmacy and stroke (OR = 1.335; 95% CI (0.532–3.346), P = 0.538, I2 = 45%), and hospitalization (OR = 1.723; 95% CI (0.983–3.021), P = 0.057, I2 = 57%). Conclusions: Pooled risk estimates reveal that polypharmacy is associated with increased all-cause mortality, macrovacular complications and hospitalization using categorical definitions. These findings assert the need for interventions that optimize the balance of benefits and harms in medicines prescribing.
| Original language | English |
|---|---|
| Article number | 107804 |
| Journal | Diabetes Research and Clinical Practice |
| Volume | 155 |
| DOIs | |
| Publication status | Published - 1 Sep 2019 |
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Keywords
- Elderly
- Multimorbidity
- Polypharmacy
- Type 2 diabetes mellitus
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The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis. / AL-Musawe, Labib; Martins, Ana Paula; Raposo, Joao Filipe; Torre, Carla.
In: Diabetes Research and Clinical Practice, Vol. 155, 107804, 01.09.2019.Research output: Contribution to journal › Review article
TY - JOUR
T1 - The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis
AU - AL-Musawe, Labib
AU - Martins, Ana Paula
AU - Raposo, Joao Filipe
AU - Torre, Carla
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Aim: To summarize the existing literature concerning the association between polypharmacy and adverse health consequences in elderly patients with type 2 diabetes mellitus. Methods: We searched four literature databases (PubMed/Medline, ScienceDirect and Web of Science) through April 2019. We included all studies that addressed the association between polypharmacy and all-cause of mortality, glycemic control, macrovacular complications, hospitalization, potentially inappropriate medicines, drug-drug interactions and fall. A statistical program OpenMeta [Analyst] was used. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random effects model. I2 statistics was performed to assess heterogeneity. Results: Out of sixteen studies, three studies were used for meta-analysis. A statistically significant association was found between polypharmacy and all-cause mortality (OR = 1.622, 95% CI (1.606–1.637) P < 0.001), and myocardial infarction (OR = 1.962, 95% CI (1.942–1.982), P < 0.001. Non-statistically significant association with evidence of moderate heterogeneity was found between polypharmacy and stroke (OR = 1.335; 95% CI (0.532–3.346), P = 0.538, I2 = 45%), and hospitalization (OR = 1.723; 95% CI (0.983–3.021), P = 0.057, I2 = 57%). Conclusions: Pooled risk estimates reveal that polypharmacy is associated with increased all-cause mortality, macrovacular complications and hospitalization using categorical definitions. These findings assert the need for interventions that optimize the balance of benefits and harms in medicines prescribing.
AB - Aim: To summarize the existing literature concerning the association between polypharmacy and adverse health consequences in elderly patients with type 2 diabetes mellitus. Methods: We searched four literature databases (PubMed/Medline, ScienceDirect and Web of Science) through April 2019. We included all studies that addressed the association between polypharmacy and all-cause of mortality, glycemic control, macrovacular complications, hospitalization, potentially inappropriate medicines, drug-drug interactions and fall. A statistical program OpenMeta [Analyst] was used. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random effects model. I2 statistics was performed to assess heterogeneity. Results: Out of sixteen studies, three studies were used for meta-analysis. A statistically significant association was found between polypharmacy and all-cause mortality (OR = 1.622, 95% CI (1.606–1.637) P < 0.001), and myocardial infarction (OR = 1.962, 95% CI (1.942–1.982), P < 0.001. Non-statistically significant association with evidence of moderate heterogeneity was found between polypharmacy and stroke (OR = 1.335; 95% CI (0.532–3.346), P = 0.538, I2 = 45%), and hospitalization (OR = 1.723; 95% CI (0.983–3.021), P = 0.057, I2 = 57%). Conclusions: Pooled risk estimates reveal that polypharmacy is associated with increased all-cause mortality, macrovacular complications and hospitalization using categorical definitions. These findings assert the need for interventions that optimize the balance of benefits and harms in medicines prescribing.
KW - Elderly
KW - Multimorbidity
KW - Polypharmacy
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85070976550&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2019.107804
DO - 10.1016/j.diabres.2019.107804
M3 - Review article
VL - 155
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
M1 - 107804
ER -