OBJECTIVES: To describe patterns of prescription medication use and polypharmacy among Chinese patients with diabetes.

METHODS: Data were extracted from the Yinzhou Health Information System, a regional population electronic health records data platform (2015.1.1-2021.10.1) with high population coverage (98%) in Yinzhou, Ningbo, China. Patients were included if they had at least two outpatient diagnoses of diabetes with an interval of ≥30 days between diagnoses or one inpatient diagnosis of diabetes, with the earliest date fulfilling diagnostic criteria as the enrollment date. Patients were followed until death or the last prescribing record within the study timeframe. Patients with gestational diabetes were excluded. Polypharmacy was defined as the use of ≥ five medications.

RESULTS: A total of 10,180 patients were included, with mean age of 61.48 (SD 12.7) years and 48.42% being male. The median (interquartile range) follow-up duration was 3.7 years (1.83, 5.58). The mean number of medications used per month for patients with diabetes increased from 2.93 at enrollment to 3.96 at sixth year of follow-up. The prevalence of polypharmacy increased from 21.89% to 37.22%, and the proportion using ≥10 medications increased from 2.64% to 5.51%. The number of medications was higher among ≥65 years adults: with a mean of 4 medications per month and prevalence of polypharmacy increasing from 28.61% to 45.91%. The most commonly used medications were glucose-lowering agents (prevalence 86.4%), oral traditional Chinese medicines (73.0%), anti-infective drugs (59.2%), and antihypertensive medications (58.5%). The prevalence of anti-infective, antihypertensive, and dermatologic drugs increased over follow-up.

CONCLUSIONS: Using longitudinal data from a district in China, we showed that patients with diabetes had high medication use, especially among older adults. In addition to glucose-lowering medication, anti-infective, antihypertensive and traditional Chinese medicine were commonly used. The growing medication burden among patients with diabetes warrants attention about appropriate use of medication in this population.