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Polypharmacy among patients with diabetes: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia
  1. Monira Alwhaibi1,2,
  2. Bander Balkhi1,2,
  3. Tariq M Alhawassi1,2,3,
  4. Hadeel Alkofide1,
  5. Nouf Alduhaim1,
  6. Rawan Alabdulali1,
  7. Hadeel Drweesh1,
  8. Usha Sambamoorthi4
  1. 1 Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
  2. 2 Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
  3. 3 Pharmacy Service, King Saud University Medical City, Riyadh, Saudi Arabia
  4. 4 Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
  1. Correspondence to Dr Monira Alwhaibi; malwhaibi{at}


Objectives Patients with diabetes are at high risk for polypharmacy (ie, use of multiple medications) for treatment of diabetes, associated comorbidities and other coexisting conditions. This study aims to estimate the prevalence of polypharmacy and factors associated with polypharmacy among adult patients with diabetes.

Methods A cross-sectional retrospective observational study of adults with diabetes, who visited the outpatient clinic of a tertiary teaching hospital in Saudi Arabia, was conducted. Data were extracted from the Electronic Health Record database for a period of 12 months (January–December 2016). Polypharmacy was defined as the cumulative use of five or more medications. Polypharmacy among adults with diabetes was measured by calculating the average number of medications prescribed per patient. A multivariable logistic regression model was used to examine the factors associated with polypharmacy.

Results A total of 8932 adults with diabetes were included in this study. Of these, nearly 78% had polypharmacy which was more likely among women as compared with men and more likely among older adults (age ≥60 years) as compared with the adults. Also, polypharmacy was two times as likely among patients with coexisting cardiovascular conditions (adjusted OR (AOR)=2.89; 95% CI 2.54 to 3.29), respiratory disease (AOR=2.42; 95% CI 1.92 to 3.03) and mental health conditions (AOR=2.19; 95% CI 1.74 to 2.76), and three times as likely among patients with coexisting musculoskeletal disease (AOR=3.16; 95% CI 2.31 to 4.30) as compared with those without these coexisting chronic conditions categories.

Conclusions Polypharmacy is common among patients with diabetes, with an even higher rate in older adults patients. Healthcare providers can help in detecting polypharmacy and in providing recommendations for simplifying medication regimens and minimising medications to enhance the outcome of diabetes care.

  • epidemiology
  • drug use evaluation

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  • Contributors MA, BB, TMA, HA, NA, RA, HD and US participated in designing the study, drafting the manuscript, analysis, interpretation of the findings, revising the manuscript content and gave final approval of the final version of this manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Board (IRB) at King Saud University Medical City approval was obtained to conduct the study (IRB number: E-17–2601).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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