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The British Journal of Diabetes & Vascular Disease
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The problem of polypharmacy in type 2 diabetes

Alistair Emslie-Smith

The DARTS/MEMO Collaboration, University of Dundee, aemslie-smith{at}fintry.finix.org.uk

Jon Dowall

Tayside Centre for General Practice, University of Dundee

Andrew Morris

The DARTS/MEMO Collaboration, University of Dundee

Evidence of improvements in outcomes gained by aggressive treatment of hypertension, hyperglycaemia and Edyslipidaemia in type 2 diabetic patients has encouraged the setting of ambitious targets for risk factor control. The therapeutic regimens needed to achieve tight control results in polypharmacy for many patients. The recent DARTS Study demonstrated poor adherence to oral hypoglycaemic drug therapy, particularly in patients prescribed combination oral hypoglycaemic drug therapy, multiple daily dose regimens and co-medications. This suggests that simplifying drug regimens, minimising tablet-counts and the use of once-daily and modified-release preparations and of fixed-combination drug preparations may be important. With regard to taking medication an alliance is needed which allows greater mutual understanding and agreement between patient and doctor. This move towards `concordance' in care planning is also crucial to success.

Key Words: polypharmacy • adherence • concordance • therapeutic alliance.

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 1, 54-56 (2003)
DOI: 10.1177/14746514030030010901
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