Associations between polypharmacy and treatment intensity for hypertension and diabetes: a cross-sectional study of nursing home patients in British Columbia, Canada

Objectives: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (over treatment) and polypharmacy. Design: Cross sectional study. Setting: 6 nursing homes in British Columbia, Canada. Participants: 214 patients, residing in one of selected facilities during data collection period. Primary and secondary outcome measures: Polypharmacy was defined as >=9 regular medications. Over treatment of diabetes was defined as being prescribed at least one hypoglycemic medication and a glycosylated hemoglobin (A1c) <=7.5%. Over treatment of hypertension required being prescribed at least one hypertension medication and having a systolic blood pressure (SBP) <=128 mmHg. Polypharmacy prescribing, independent of over treatment, was calculated by subtracting disease specific medications from total medications prescribed. Results: D...