A study of potential adverse drug-drug interactions among prescribed drugs in medicine outpatient department of a tertiary care teaching hospital

Abstract

Objective:To evaluate prevalence, types, and severity of potential adverse drug-drug interaction in medicine out-patient department.Materials and Methods:A single-point, prospective, and observational study was carried out in medicine OPD. Study began after obtaining approval Institutional Ethics Committee. Data were collected and potential drug-drug interactions (pDDIs) were identified using medscape drug interaction checker and were analyzed.Result:A total of 350 prescriptions with mean age 52.45 ± 14.49 years were collected over a period of 5 months. A total of 2066 pDDIs were recorded with mean of 5.90 ± 6.0. The prevalence of pDDI was 83.42%. Aspirin was most frequently prescribed drug in 185 (10.15%) out of total of 1821 drugs It was also the most frequent drug implicated in pDDI i.e. in 48.16%. The most common pDDI identified was metoprolol with aspirin in 126 (6.09%). Mechanism of interactions was pharmacokinetic in 553 (26.76%), pharmacodynamic in 1424 (68.92%) and 89 (4.30%) having an unknown mechanism. Out of all interactions, 76 (3.67%) were serious, 1516 (73.37%) significant, and 474 (22.94%) were minor interaction. Age of the patients (r = 0.327, P = 0.0001) and number of drugs prescribed (r = 0.714, P = 0.0001) are significantly correlated with drug interactions.Conclusion:Aspirin being the most common drug interacting. The use of electronic decision support tools, continuing education and vigilance on the part of prescribers toward drug selection may decrease the problem of pDDIs.

Study of Drug-Drug Interactions in General Medicine Department of a Tertiary Care Hospital

“…It was similar to the study conducted by Patel et al, 2011, Riechelmann et al, 2007, Riechelmann et al, 2008, Dinesh et al, 2007 Of the pDDIs (n=390) observed, majority were of pharmacodynamic (n=202, 51.80%) in nature followed by pharmacokinetic (n=188, 48.20%). These findings were contrast to the study reported by Vonbach et al, 2008 andAparasu et al, 2007. Most frequent DDI was seen between Metformin + Ranitidine (moderate interaction) in 70 prescriptions (50%) and between Ranitidine + Acetaminophen (minor interaction) in 48 prescriptions (34.29%). The common major interactions were seen between Rabeprazole + Clopidogrel in 4 prescriptions (2.86%), Enalapril + Spironolactone and Ciprofloxacin + Tramadol in 3 prescriptions (2.14%).…”

“…Adding each drug combination increases chances of further DDI. Special attention and thorough monitoring is definitely required for the patients who are at the most risk of developing pDDIs (Rana et al, 2014). Now-a-days, many patients are on polypharmacy for treating their disease conditions and there are many interactions between the drugs prescribed in each prescription.…”

A study of medication errors in a tertiary care hospital

“…and Sepehri et al . [2223] Surprisingly, nine serious reactions were observed with ondansetron. However, their potential to cause serious DDI has been neglected by prescribers.…”

Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study

“…Up to our knowledge, studies concerning the nature and prevalence of pDDIs in the outpatient department (OPD) of Pakistani hospitals remains unaddressed. Some studies from the developed countries have reported a prevalence rate of 28–83% for pDDIs in OPD [ 4 , 14 , 16 – 19 ]. These studies are limited by the nature of study settings, design, DDIs screening tool, and drug prescribing pattern.…”