Effectiveness of countermeasure for polypharmacy by multidisciplinary team review in patients with diabetes mellitus

IF 3.2 3区医学 Journal of Diabetes Investigation Pub Date : 2023-06-25 DOI:10.1111/jdi.14046

Shohei Nishida, Takehiro Kato, Yuichi Hayashi, Shoya Yamada, Hironori Fujii, Michi Yamada, Nao Asai, Shinya Shimizu, Takashi Niwa, Hirotoshi Iihara, Sodai Kubota, Mayu Sakai, Yoshihiro Takahashi, Ken Takao, Masami Mizuno, Takuo Hirota, Ryo Kobayashi, Yukio Horikawa, Daisuke Yabe, Akio Suzuki

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引用次数: 1

Abstract

Aims/Introduction

Polypharmacy in diabetes patients is related to worse clinical outcomes. The aim of this study was to evaluate the usefulness of our countermeasure for polypharmacy, which combines a pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy.

Methods

A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included diabetic patients taking six or more drugs on admission to the diabetes ward between July 2021 and June 2022. Drugs which were discontinued by the present countermeasure were examined, and the number of drugs being taken by each patient was compared between admission and discharge.

Results

102 of 308 patients were taking six or more drugs on admission. The drugs being taken by these patients were evaluated by pharmacists using a checklist for polypharmacy. Eighty-four drugs which were evaluated as inappropriate or potentially inappropriate medications by pharmacists were discontinued following the multidisciplinary team review. The median and mean number of drugs taken by the 102 patients significantly decreased from 9.0 (IQR: 8–12) and 9.26 ± 2.64 on admission to 9.0 (IQR: 6–10) and 8.42 ± 2.95 on discharge (P = 0.0002). We followed up with these patients after discontinuation of the drugs and confirmed that their clinical status had not deteriorated.

Conclusion

The present countermeasure for polypharmacy, which combines a pharmacist check based on a checklist for evaluating polypharmacy followed by a multidisciplinary team review, was useful for reducing the number of inappropriate or potentially inappropriate medications taken by diabetes patients with polypharmacy.

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多学科团队评审对糖尿病患者多药治疗对策的有效性

目的/简介糖尿病患者的多药治疗与较差的临床结果有关。本研究的目的是评估我们的多药对策的有效性，该对策结合了药剂师检查和多学科团队对糖尿病多药患者的审查。方法在岐阜大学医院进行单中心回顾性观察研究。研究参与者包括2021年7月至2022年6月期间入住糖尿病病房时服用六种或六种以上药物的糖尿病患者。检查了因本对策而停用的药物，并比较了每位患者在入院和出院期间服用的药物数量。结果308例患者中有102例在入院时服用了6种或6种以上药物。药剂师使用多药对照表对这些患者服用的药物进行了评估。在多学科团队审查后，药剂师评估为不合适或潜在不合适药物的84种药物被停用。102名患者服用药物的中位数和平均数从9.0（IQR:8-12）和9.26显著下降 ± 入院时为2.64（IQR:6-10）和8.42 ± 2.95出院时（P = 0.0002）。我们在停药后对这些患者进行了随访，并确认他们的临床状况没有恶化。结论目前的多药治疗对策是，在评估多药治疗的检查表的基础上进行药剂师检查，然后进行多学科团队审查，这有助于减少糖尿病多药患者服用不适当或潜在不适当药物的数量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Investigation Medicine-Internal Medicine

自引率

9.40%

发文量

218

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).