Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Background: Diabetics are usually with several co morbidities, necessitating the use of multiple medications. Studies have shown that the use of many medications is connected to negative health outcomes like adverse medication reactions and medication-medication interactions. Aim: A controlled polypharmacy among diabetics attending Kasr Al-ainy Diabetes Clinic (KADC). This is through estimating polypharmacy among a group of KADC attendants, identifying associated factors and suggested solutions. Methodology: A cross sectional study. A purposive -non random- sample of 219 adult diabetics who were repeated utilizers of KADC were interviewed. In depth interview was conducted with five of KADC physicians. Utilization records of KADC were reviewed. A five and more medications in the previous week was used to define polypharmacy. Results: The prevalence of polypharmacy was 22.8%. Age ({u2265}60 years), duration since diagnosed as diabetic ({u2265}5 years), using both insulin and oral hypoglycemics, number of visits to KADC (> 6 visits) and viewing polypharmacy as harmful were found to be significantly associated with polypharmacy. Among the interviewed physicians, there was no consensus regarding the definition of polypharmacy, and consequently its prevalence among KADC attendants. There was a consensus that multiple medications in managing diabetes and co morbidities may be the case, however, in need of a responsible review from KADC physician. The low economic and educational levels of KADC attendants are aggravating the problem. Conclusion: Use of multiple medications may be the case among patients with a chronic disease with co morbidities like diabetes. However, irrational use among KADC attandents is a function of poor economic and educational status. Greater responsibility is shouldered by the caring physicians in controlling polypharamcy

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