Rising Polypharmacy Trends and Associated Factors in Chinese Adults With Diabetes: A Population-Based Cohort Study
Author(s)
Nan Peng, Ph.D.1, Xian Zhang, MAE2, Linfeng Jiang, BS3, Jinbo Zhang, BS4, Yuqing Fan, BS3, Jiale Yang, BS4, Dongning Yao, Ph.D.3, Pei Gao, Ph.D.2, Yexiang Sun, BS5, Hongbo Lin, BS5, Jing Wu, PhD1, Gordon Liu, PhD2, Beini Lyu, Ph.D.2.
1Tianjin University, Tianjin, China, 2Peking University, Beijing, China, 3Nanjing Medical University, Nanjing, China, 4China Pharmaceutical University, Nanjing, China, 5Yinzhou District Center for Disease Control and Prevention, Ningbo, China.
1Tianjin University, Tianjin, China, 2Peking University, Beijing, China, 3Nanjing Medical University, Nanjing, China, 4China Pharmaceutical University, Nanjing, China, 5Yinzhou District Center for Disease Control and Prevention, Ningbo, China.
OBJECTIVES: China has the largest diabetes population globally, straining its healthcare system. Managing diabetes often requires multiple medications, increasing the risk of polypharmacy. However, longitudinal evidence on medication use and polypharmacy among Chinese patients with diabetes is limited. This study aimed to examine trends in medication use and polypharmacy and identify associated factors in a large population-based cohort in China.
METHODS: The retrospective cohort study used data from the Yinzhou Regional Health Care Database, covering all health institutions in Yinzhou District, Ningbo. Adults (≥18 years) with diabetes (≥2 outpatient diagnoses [≥30 days apart] or 1 inpatient diagnosis)and with at least one prescription between 2015 and 2021 were enrolled. Patients were followed until death, loss to follow-up, or study end. Polypharmacy was defined as using ≥5 medications. Logistic regression assessed trends and associated factors.
RESULTS: The cohort comprised 99,619 patients (mean age 61.6±12.5 years, 48.4% female) with median follow-up of 3.5 years (IQR 1.6-5.5). The average number of medications per patient monthly increased from 2.8 in 2015 to 3.6 in 2021. Polypharmacy prevalence rose from 18.4% to 32.6% (p-for-trend <0.01). Older age, male sex, comorbidities, and urban insurance were associated with polypharmacy. Glucose-lowering and cardiovascular medications were the most used; traditional Chinese patent medications (70%) and antibacterial agents were also common.
CONCLUSIONS: Polypharmacy was prevalent among Chinese patients with diabetes. Alongside glucose-lowering and cardiovascular medications, antibacterial and traditional Chinese patent medications were commonly used. The growing medication burden calls for attention to appropriate use.
METHODS: The retrospective cohort study used data from the Yinzhou Regional Health Care Database, covering all health institutions in Yinzhou District, Ningbo. Adults (≥18 years) with diabetes (≥2 outpatient diagnoses [≥30 days apart] or 1 inpatient diagnosis)and with at least one prescription between 2015 and 2021 were enrolled. Patients were followed until death, loss to follow-up, or study end. Polypharmacy was defined as using ≥5 medications. Logistic regression assessed trends and associated factors.
RESULTS: The cohort comprised 99,619 patients (mean age 61.6±12.5 years, 48.4% female) with median follow-up of 3.5 years (IQR 1.6-5.5). The average number of medications per patient monthly increased from 2.8 in 2015 to 3.6 in 2021. Polypharmacy prevalence rose from 18.4% to 32.6% (p-for-trend <0.01). Older age, male sex, comorbidities, and urban insurance were associated with polypharmacy. Glucose-lowering and cardiovascular medications were the most used; traditional Chinese patent medications (70%) and antibacterial agents were also common.
CONCLUSIONS: Polypharmacy was prevalent among Chinese patients with diabetes. Alongside glucose-lowering and cardiovascular medications, antibacterial and traditional Chinese patent medications were commonly used. The growing medication burden calls for attention to appropriate use.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD100
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas