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

Author:

Nishida Shohei1ORCID,Kato Takehiro23ORCID,Hayashi Yuichi4ORCID,Yamada Shoya1,Fujii Hironori1ORCID,Yamada Michi1,Asai Nao1,Shimizu Shinya1,Niwa Takashi1,Iihara Hirotoshi15ORCID,Kubota Sodai23ORCID,Sakai Mayu23,Takahashi Yoshihiro23ORCID,Takao Ken23,Mizuno Masami23,Hirota Takuo23,Kobayashi Ryo16ORCID,Horikawa Yukio237ORCID,Yabe Daisuke238910ORCID,Suzuki Akio16ORCID

Affiliation:

1. Department of Pharmacy Gifu University Hospital Gifu Japan

2. Department of Diabetes, Endocrinology and Metabolism Gifu University Graduate School of Medicine Gifu Japan

3. Department of Rheumatology and Clinical Immunology Gifu University Graduate School of Medicine Gifu Japan

4. Faculty of Nursing Science Tsuruga Nursing University Tsuruga Japan

5. Patient Safety Division Gifu University Hospital Gifu Japan

6. Laboratory of Advanced Medical Pharmacy Gifu Pharmaceutical University Gifu Japan

7. Center for Patient Flow Management Gifu University Hospital Gifu Japan

8. Center for One Medicine Innovative Translational Research Gifu University Institute for Advanced Study Gifu Japan

9. Preemptive Food Research Center Gifu University Institute for Advanced Study Gifu Japan

10. Center for Research, Education and Lifestyle Design Gifu University Gifu Japan

Abstract

ABSTRACTAims/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 ± 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.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.

Funder

Ministry of Education, Culture, Sports, Science and Technology

Publisher

Wiley

Subject

General Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

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