Predictors of medication regimen complexity and its impact on hemoglobin a1c in type 2 diabetes patients: a retrospective analysis in ambulatory care in Makkah City

BACKGROUND:
Type 2 diabetes mellitus (T2DM) is a widespread chronic disease that poses a significant management challenge due to the complexity of the associated medication regimens, which can have a considerable impact on patient outcomes.


OBJECTIVES:
Explore the complexity level of diabetes medications among patients with T2DM and to identify the predictors of medication regimen complexity (MRC) and its correlation with hemoglobin A1C (HbA1c) levels.


DESIGN:
Retrospective, cross-sectional study


SETTING:
An ambulatory care setting of a tertiary hospital in Makkah City, Saudi Arabia


PATIENTS AND METHODS:
Patients with T2DM referred to the diabetic clinic were identified and assessed for eligibility. The data were collected from patient electronic medical records between October 2022 and September 2023. The MRC Index was used to evaluate the complexity of the patients’ medication regimens.


MAIN OUTCOMES MEASURES:
MRC index scores and HbA1c levels


SAMPLE SIZE:
353 records of patients with T2DM


RESULTS:

The analysis revealed that 61.8% (n=218) of patients had high MRC, with the dosing frequency contributing significantly to their MRC (mean=3.9, SD=1.9). Having polypharmacy and longstanding T2DM were predictors of high MRC (odds ratios=4.9 and 2.6, respectively;
P
≤.01). Additionally, there was an inverse association between the patients’ diabetes-specific MRC index scores and their glycemic control (odds ratios=0.2,
P
<.001).



CONCLUSION:
The study findings highlight the importance of considering MRC in managing T2DM. Simplifying medication regimens and optimizing medication management strategies can improve patient outcomes. Further research is needed to explore interventions to reduce MRC and enhance diabetes management in this population.


LIMITATIONS:
Retrospective study design measuring the MRC at a diabetes-specific level.