Wise Prescriptions: Prevalence and Predictors of Polypharmacy in Patients with Type 2 Diabetes Mellitus in Primary Care: A Retrospective Cross-Sectional Study

Background/Objectives: Diabetes mellitus is a common chronic disease that may lead to multimorbidity and high drug use. Therefore, this study aims to examine the prevalence of polypharmacy and hyperpolypharmacy among adult patients diagnosed with type 2 diabetes mellitus (T2DM) with its associated factors. Methods: This is a retrospective cross-sectional study conducted from 1 May 2023 to 31 October 2024. The outcomes in our study were polypharmacy (from five to nine drugs) and hyperpolypharmacy (≥10 drugs). Baseline and demographic characteristics, along with multinomial logistic regression, were used to analyze the data. Results: The total number of patients with T2DM was 2435. The prevalence rate of polypharmacy was 46.98%, while hyperpolypharmacy was 24.27%. Older age was significantly associated with a higher risk of polypharmacy [OR = 1.031, 95% (1.022–1.040)] and hyperpolypharmacy [OR = 1.037, 95% (1.026–1.049)]. In addition, patients with higher levels of hemoglobin A1c showed a significantly higher risk of polypharmacy and hyperpolypharmacy ([OR = 1.162, 95% (1.105–1.221)] and [OR = 1.284, 95% (1.209–1.364)], respectively). The comorbidities that increased the odds of hyperpolypharmacy were hypertension [OR = 2.136, 95% (1.449–3.148)], pulmonary disease [OR = 2.375, 95% (1.292–4.367)], mental disorders [OR = 6.269; 95% (3.284–11.964], and congestive heart failure [OR = 8.014, 95% (2.768–23.200)]. Conclusions: The prevalence of polypharmacy and hyperpolypharmacy is high in patients with T2DM. The predictors that may play a significant role in increasing the risk of hyperpolypharmacy are the poor control of HbA1c and the coexistence of comorbidities. Providing proper prescribing of patients’ therapy plans can improve individuals’ health outcomes. Therefore, this study highlights the important role of primary care physicians in coordinating care, along with clinical pharmacists, in the identification of polypharmacy.