Examining inappropriate medication in UK primary care for type 2 diabetes patients with polypharmacy

AimsTo estimate the prevalence of potentially inappropriate prescriptions (PIPs) in patients starting their first non-insulin antidiabetic treatment (NIAD) using two explicit process measures of the appropriateness of prescribing in UK primary care, stratified by age and polypharmacy status. MethodsA descriptive cohort study between 2016 and 2019 was conducted to assess PIPs in patients aged [≥]45 years at the start of their first NIAD, stratified by age and polypharmacy status. The American Geriatrics Society (AGS) Beers criteria 2015 was used for older ([≥]65 years) and the Prescribing Optimally in Middle-age Peoples Treatments (PROMPT) criteria for middle-aged (45-64 years) patients. Prevalence of overall PIPs and individual PIPs criteria was reported using the IQVIA Medical Research Data incorporating THIN, a Cegedim Database of anonymised electronic health records in the UK. ResultsAmong 28,604 patients initiating NIADs, 18,494 (64.7%) received polypharmacy. In older and middle-aged patients with polypharmacy, 39.6% and 22.7%, respectively, received [≥]1 PIPs. At the individual PIPs level, long-term PPI use and strong opioid without laxatives were the most frequent PIPs among older and middle-aged patients with polypharmacy (11.1% and 4.1%, respectively). ConclusionsThis study revealed that patients starting NIAD treatment receiving polypharmacy have the potential for pharmacotherapy optimisation.