Abstract / Summary
Abstract Background Polypharmacy is commonly defined using counts of individual medicines, but definitions vary and category-based measures capture a different construct. We described therapeutic-category medication burden and associated sociodemographic patterns among adults with treated diabetes in the Health Survey for England (HSE) 2022 nurse-visit analytical sample. Methods Cross-sectional HSE 2022 data included adults (≥ 16 years) who completed the nurse visit, reported diabetes, and received antidiabetic treatment ( N = 262). Medication burden was the number of six broad therapeutic categories with ≥ 1 prescribed medicine taken in the past 7 days; the primary outcome was ≥ 3 categories. Analyses were unweighted and describe the selected analytical sample rather than population-level prevalence. Logistic regression examined age, sex and area deprivation; treatment-modality analyses included 256 participants with classifiable treatment status. Sensitivity analyses examined stricter thresholds of ≥ 4 and ≥ 5 categories and alternative outcome definitions excluding antibacterial medications and excluding both antibacterial medications and NSAIDs. Results Overall, 107/262 participants (40.8%; exact 95% CI 34.8–47.1) met the ≥ 3-category threshold. The 55–64-year group had higher adjusted odds than the < 55 group (aOR 3.07, 95% CI 1.12–8.46), and the most deprived quintile had higher odds than the least deprived quintile (aOR 3.21, 95% CI 1.38–7.47); however, overall Wald tests for age ( p = 0.128) and deprivation ( p = 0.089) were not statistically significant. No statistically significant differences were detected across treatment groups (overall Wald p = 0.824), and estimates were imprecise, particularly for insulin-only users. Using stricter thresholds, 11.1% (29/262; 95% CI 7.5–15.5) met the ≥ 4-category threshold and 3.4% (9/262; 95% CI 1.6–6.4) met the ≥ 5-category threshold. Excluding antibacterial medications had little effect on the ≥ 3-category proportion (40.5%), whereas excluding both antibacterial medications and NSAIDs reduced it to 35.9%. Conclusions In this HSE nurse-visit analytical sample, about two in five participants met the study-specific ≥ 3-category medication-burden threshold. Higher burden was observed in some age and deprivation groups, while no clear differences were detected across diabetes treatment modalities. The findings highlight the breadth of therapeutic-category exposure among adults with treated diabetes and the potential value of comprehensive medication review that considers both clinical and socioeconomic context.