Personne : Plante, Céline
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Plante
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Céline
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Université Laval. Département des sciences des aliments et de nutrition
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ncf10567882
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Publication Accès libre Polypharmacy and pharmacological treatment of diabetes in older individuals : a population-based study in Quebec, Canada(MDPI AG, 2019-12-01) Plante, Céline; Simard, Marc; Gagnon, Marie-Ève; Sirois, CarolineOur objectives were to describe the use of pharmacological treatments in older adults with diabetes and to identify the factors associated with the use of a combination of hypoglycemic, antihypertensive and lipid-lowering agents. Using the Quebec Integrated Chronic Disease Surveillance System, we conducted a population-based cohort study among individuals aged 66–75 years with diabetes in 2014-2015. We described the number of medications and the classes of medications used and calculated the proportion of individuals using at least one medication from each of these classes: hypoglycemics, antihypertensives and lipid-lowering agents. We identified the factors associated with the use of this combination of treatments by performing robust Poisson regressions. The 146,710 individuals used an average of 12 (SD 7) different medications, mostly cardiovascular (91.3% of users), hormones, including hypoglycemic agents (84.5%), and central nervous system medications (79.8%). The majority of individuals (59%) were exposed to the combination of treatments and the factor most strongly associated was the presence of cardiovascular comorbidities (RR: 1.29; 99% CI: 1.28-1.31). Older individuals with diabetes are exposed to a large number of medications. While the use of the combination of treatments is significant and could translate into cardiovascular benefits at the population level, the potential risk associated with polypharmacy needs to be documented.Publication Restreint Potentially inappropriate medications in older individuals with diabetes : a population-based study in Quebec, Canada(Elsevier, 2020-05-10) Gagnon (médecine préventive), Marie-Eve; Plante, Céline; Simard, Marc; Sirois, CarolineAim: To study the population-based prevalence of potentially inappropriate medication (PIM) among older individuals with diabetes, and to identify factors associated with their use. Methods: We used the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database to conduct a population-based cohort study of individuals with diabetes ≥66 years between April 1st, 2014 and March 31st, 2015. PIMs were defined according to the 2015 Beers Criteria. Factors associated with PIM use were identified using robust Poisson regression models. Risk ratios (RR) and 99% confidence intervals (99%CI) were calculated. Results: More than half (56%) of the 286,962 older individuals with diabetes used at least one PIM over a year. Benzodiazepines (41%), proton pump inhibitors (27%) and endocrine medication (mainly glibenclamide) (25%) were the most common PIMs used. Factors associated with PIM use included female sex (RR: 1.17; 99%CI: 1.16–1.18), and comorbidities such as schizophrenia (1.48; 1.45–1.51), anxiety disorders (1.34; 1.33–1.35) and Alzheimer’s disease (1.14; 1.13–1.25). Risks of using PIMs increased both with increasing comorbidities and number of medications. Conclusion: PIM use is highly prevalent among older individuals with diabetes. Interventions to promote optimal medication use should particularly targetindividuals with comorbidities and polypharmacy who are most vulnerable to adverse drug events.