| Abstract [eng] |
Title. Drug Interactions in Patients with Diabetes and Multimorbidity. The aim. To identify clinically significant drug interactions in patients with diabetes and multimorbidity. Objectives. 1. To determine the nature and frequency of comorbidities and the number of drugs used in patients with diabetes. 2. To determine the differences in the frequency of drug interactions between patients with concordant and discordant comorbidities. 3. To assess the characteristics of age, weight and renal function of patients with potential drug interactions. Methods. A prospective study was conducted by analyzing the data of patients participating in the biomedical study “Relation between patient-centered care, treatment engagement and disease control in patients with diabetes and multimorbidity”. Permission to conduct the study was obtained from the Vilnius Regional Ethics Committee for Biomedical Research. Demographic, anamnesis’, anthropometric and disease control data of patients were evaluated, assessment of used medications and drug interactions was performed. The significance level chosen for testing statistical hypotheses was α=0.05. Results. 73% of all patients were diagnosed with diabetic polyneuropathy, 8% were diagnosed with retinopathy and 6% were diagnosed with nephropathy. 13% of individuals had atherosclerotic cardiovascular disease, 25% of patients aged 55 years or more had risk factors for cardiovascular disease. 5 study participants were diagnosed with stage 3 or stage 4 chronic kidney disease. 58% of all patients with diabetes had discordant comorbidities: 41% had diseases affecting spine and joints and causing pain, 22% suffered from depression or had symptoms of depression, 15% had hypothyroidism and 7% had bronchial asthma. Diabetes control of 59% of participants was within the target range according to the individual target HbA1c, which was mostly achieved by patients with a target HbA1c of 6.5% or below. 72 individuals with diabetes were prescribed with oral therapy, 38 of them received metformin monotherapy. 24 patients used insulin, 9 of them were treated with insulin monotherapy and the remaining 15 used insulin combined with oral therapy, 4 patients followed a diet. 28% of all study participants were identified with 1 to 2 potential drug interactions, 14% were identified with 3 or more potential drug interactions and no interactions were identified in 58% of all patients. Conclusions. 1. The most common comorbidities in patients with diabetes are arterial hypertension and cardiovascular disease. Patients with diabetes are often prone to polypharmacy. 2. Potential drug interactions were identified more often in study participants with diabetes and discordant comorbidities than in study participants with concordant comorbidities. 3. Patients with diabetes and concordant comorbidities were identified with potential drug interactions between drugs affecting cardiovascular system, lipid-lowering agents and diabetes medications. Patients with diabetes and discordant comorbidities were identified with potential drug interactions between drugs affecting the nervous system, medications for bronchial asthma or other respiratory diseases, thyroid hormones and non-steroidal anti-inflammatory drugs. 4. Patients identified with potential drug interactions had statistically significantly smaller height and greater body mass index than those who were not identified with drug interactions. No statistically significant differences in age, weight and renal function were found between individuals who were and were not identified with drug interactions. |
