The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients; a systematic review and meta-analysis

Labib AL-Musawe, Ana Paula Martins, Joao Filipe Raposo, Carla Torre

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14 Citations (Scopus)

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 languageEnglish
Article number107804
JournalDiabetes Research and Clinical Practice
Volume155
DOIs
Publication statusPublished - 1 Sep 2019

Keywords

  • Elderly
  • Multimorbidity
  • Polypharmacy
  • Type 2 diabetes mellitus

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