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Year:: 2021
Contributor:: Baker, Julianne (Author); Nassar, Carolynn (Advisor); Tobin-Tyler, Elizabeth (Advisor)
Subject:: diabetes; Polypharmacy; Comorbidities
DOI: https://doi.org/10.26300/ydm8-2n58

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Abstract:: The prevalence of diabetes in the U.S. has continued to increase. In an already aging population, chronic diseases, like diabetes, often have comorbidities that require the use of polypharmacy - the prescribing of multiple medications to an individual. While the physiological benefits of polypharmacy have been established, recent data suggests a relationship between increased number of medications and adverse clinical events. This project seeks to examine the relationship between polypharmacy and diabetes management. Hemoglobin A1c was used as the metric for determining the level of control of diabetes. The sample population consisted of diabetes patients seen at Brown Medicine, East Providence Primary Care who had not met their A1c goal < 8 by January 2021. A manual chart review of these patients (n=142) was completed and quantitative data was collected on social and medical determinants of health, including total number of medications. A two-tailed T-test showed a significant difference (p < 0.01) between the two populations. On average, patients with an A1c > 8 < 2 years (n=75) were on fewer medications (mean=10.805) compared to patients (n=64) with an A1c > 8 > 2 years (mean=13.765). Overall, 88% of patients with an A1c > 8 < 2 years and 94% of patients with an A1c > 8 > 2 years were experiencing polypharmacy. Patients with longer uncontrolled diabetes were on significantly more medications than those patients whose A1c > 8 for less than 2 years. Additionally, polypharmacy has been linked to decreased medication adherence, increased chance of lifestyle risks, and increased adverse side effects. Pharmacist-led education of medications, ongoing counseling, and refill reminders could be a valuable resource in promoting knowledge of medications and preventing overprescription. Additionally, a greater emphasis on generalist care and provision of drug information pamphlets may be able to mitigate some of these effects.

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Rights: In Copyright
Restrictions on Use: All rights reserved. Collection is open for research.

Citation

Baker, Julianne, "Could Less Really Be More? Potential Adverse Effects of Polypharmacy for Diabetes Management" (2021). Gateways to Medicine, Health Care, and Research. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/ydm8-2n58

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Gateways to Medicine, Health Care, and Research

The Gateways Program at the Warren Alpert Medical School of Brown University provides academically promising, motivated students new pathways to careers in the health sciences. This collection houses scholarly works produced by Master of Science in Medical Sciences (ScM) students …
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Could Less Really Be More? Potential Adverse Effects of Polypharmacy for Diabetes Management