Abstract：
OBJECTIVE: We aimed to examine trends in overall prescription medication use among patients with type 2 diabetes in the United States to provide insights for patient care.
METHODS: We used nationally representative data from the National Health and Nutrition Examination Survey from 1999 to 2020 and included adult patients with type 2 diabetes. We examined the use of prescription drugs, overall and by drug class, polypharmacy (use of ≥5 medications), and number of medications attributed to specific classes.
RESULTS: In the period 2015-2020, the mean patient age was 59.6 (51.0-70.0) years, with 46.8% (43.6-49.9) being female and 57.8% (52.8-62.8) being non-Hispanic White. Among 9489 adults with type 2 diabetes, the prevalence of polypharmacy was high and increased from 35.1% (31.6-38.6) in 1999-2002 to 47.2% (43.7-50.7) in 2003-2006, and further to 51.1% (48.3-53.9) in 2015-2020 (p for trend <0.001). Increasing trends of polypharmacy were found across all population subgroups and across the majority of therapeutic classes. Use of non-cardiometabolic medications was common. Among them, the most common were antidepressants (19.8%), proton pump inhibitors (19.0%) and analgesics (16.2%). Among patients with polypharmacy, approximately 40% of medication use was attributed to non-cardiometabolic medications.
CONCLUSIONS: Prescription medication burden and complexity increased substantially among patients with type 2 diabetes, with more than 50% of patients with polypharmacy. Attention should be paid to this escalating medication use and regimen complexity, which requires multidisciplinary and coordinated care.
METHODS: We used nationally representative data from the National Health and Nutrition Examination Survey from 1999 to 2020 and included adult patients with type 2 diabetes. We examined the use of prescription drugs, overall and by drug class, polypharmacy (use of ≥5 medications), and number of medications attributed to specific classes.
RESULTS: In the period 2015-2020, the mean patient age was 59.6 (51.0-70.0) years, with 46.8% (43.6-49.9) being female and 57.8% (52.8-62.8) being non-Hispanic White. Among 9489 adults with type 2 diabetes, the prevalence of polypharmacy was high and increased from 35.1% (31.6-38.6) in 1999-2002 to 47.2% (43.7-50.7) in 2003-2006, and further to 51.1% (48.3-53.9) in 2015-2020 (p for trend <0.001). Increasing trends of polypharmacy were found across all population subgroups and across the majority of therapeutic classes. Use of non-cardiometabolic medications was common. Among them, the most common were antidepressants (19.8%), proton pump inhibitors (19.0%) and analgesics (16.2%). Among patients with polypharmacy, approximately 40% of medication use was attributed to non-cardiometabolic medications.
CONCLUSIONS: Prescription medication burden and complexity increased substantially among patients with type 2 diabetes, with more than 50% of patients with polypharmacy. Attention should be paid to this escalating medication use and regimen complexity, which requires multidisciplinary and coordinated care.
摘要：
目的：我们旨在研究美国2型糖尿病患者整体处方药使用趋势，为患者护理提供见解。
方法：我们使用了1999年至2020年全国健康和营养调查的全国代表性数据，并纳入了2型糖尿病成年患者。我们检查了处方药的使用，总体上和按药物类别，多药（使用≥5种药物），以及归因于特定类别的药物数量。
结果：在2015-2020年期间，患者的平均年龄为59.6（51.0-70.0）岁，其中46.8％（43.6-49.9）为女性，57.8％（52.8-62.8）为非西班牙裔白人。在9489名2型糖尿病成年人中，多药疗法的患病率很高,从1999-2002年的35.1%(31.6-38.6)上升至2003-2006年的47.2%(43.7-50.7),并进一步上升至2015-2020年的51.1%(48.3-53.9)(p<0.001).在所有人群亚组和大多数治疗类别中发现了多药疗法的增加趋势。使用非心脏代谢药物是常见的。其中,最常见的是抗抑郁药（19.8%），质子泵抑制剂(19.0%)和镇痛药(16.2%)。在多重用药的患者中，约40%的药物使用归因于非心脏代谢药物.
结论：2型糖尿病患者的处方药负担和复杂性显著增加，超过50％的患者使用多种药物。应注意这种不断升级的药物使用和方案复杂性，这需要多学科和协调的护理。
方法：我们使用了1999年至2020年全国健康和营养调查的全国代表性数据，并纳入了2型糖尿病成年患者。我们检查了处方药的使用，总体上和按药物类别，多药（使用≥5种药物），以及归因于特定类别的药物数量。
结果：在2015-2020年期间，患者的平均年龄为59.6（51.0-70.0）岁，其中46.8％（43.6-49.9）为女性，57.8％（52.8-62.8）为非西班牙裔白人。在9489名2型糖尿病成年人中，多药疗法的患病率很高,从1999-2002年的35.1%(31.6-38.6)上升至2003-2006年的47.2%(43.7-50.7),并进一步上升至2015-2020年的51.1%(48.3-53.9)(p<0.001).在所有人群亚组和大多数治疗类别中发现了多药疗法的增加趋势。使用非心脏代谢药物是常见的。其中,最常见的是抗抑郁药（19.8%），质子泵抑制剂(19.0%)和镇痛药(16.2%)。在多重用药的患者中，约40%的药物使用归因于非心脏代谢药物.
结论：2型糖尿病患者的处方药负担和复杂性显著增加，超过50％的患者使用多种药物。应注意这种不断升级的药物使用和方案复杂性，这需要多学科和协调的护理。
