Prevalence of Overtreatment, Polypharmacy, and Potential Candidates for Deprescribing Among Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study
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Abstract
Background: Elderly patients with Type 2 diabetes mellitus (T2DM) have special risk of overtreatment and polypharmacy due to polycomorbidities and complex medication therapy. The use of too many medications can lead to hypoglycaemia, side effects of medications, functional decline and poor quality of life, making it important to recognise the right candidates for deprescribing.
Objectives: To investigate the prevalence of overtreatment, polypharmacy and possible candidates for deprescription in elderly patients with Type 2 Diabetes Mellitus (T2DM) and to assess their clinical features.
Materials and Methods: A cross-sectional study using hospital setting was done on 200 elderly patients (≥ 65 years) who were attending the outpatient department for T2DM. The data were gathered with regard to demography, clinical, laboratory and medication details using a structured case record form. The analyses of data were carried out using IBM SPSS statistics version 26.0. The descriptive statistics, chi square and logistic regression analyses were conducted, and the significance level was set at p-value < 0.05.
Results: the mean (SD) age at which the participant was diagnosed with diabetes was 78.12 ± 7.79 years, and the mean (SD) duration of diabetes was 12.67 ± 7.09 years. Polypharmacy was found in 78.0% of participants and overtreatment was found in 16.0% of participants. Insulin and sulfonylureas were used by 40.5% and 30.0% of the patients, respectively. 19.0% reported hypoglycemia and 28.0% had frailty. In total, 74.5% of elderly patients were deemed to be potential candidates for deprescribing.
Conclusion: Polypharmacy and overtreatment are prevalent in elderly T2DM patients, and many could benefit from deprescription. Medication review, individualized glycemic targets and evidence-based deprescribing approaches can help to minimize medication-related harm and optimize the safety and quality of diabetes care for older adults.