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

Aims/IntroductionPolypharmacy 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. MethodsA 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. Results102 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 & PLUSMN; 2.64 on admission to 9.0 (IQR: 6-10) and 8.42 & PLUSMN; 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. ConclusionThe 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.

Automated summary

The aim of this study was to evaluate the usefulness of pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy. The study found that the combination of pharmacist check and multidisciplinary team review successfully reduced the use of inappropriate or potentially inappropriate medications in diabetic patients.