Drug-Drug Interactions Among Elderly Patients Hospitalized for Drug Toxicity

Abstract

DVERSE DRUG EVENTS AFFECTmillions of patients each year and are responsible for up to 5% of hospital admissions. 1,2 They also pose an enormous financial burden, with an estimated cost of more than $16000 per hospitalization. 3 While some adverse drug events are unpredictable (such as anaphylaxis from an unrecognized allergy), many others can be anticipated and prevented.Drug-drug interactions are a particularly important type of adverse drug event because they are often predictable based on previous reports, clinical studies, and an understanding of pharmacologic principles. Some adverse drug events have life-threatening consequences and may prompt the removal of popular medications from the marketplace. 4-10 Such drastic measures are probably justifiable because clinicians are often unaware of serious drug-drug interactions. [11][12][13][14][15] Moreover, the computer systems intended to help avert dangerous drug combinations fail to detect up to a third of drugdrug interactions, while frequently alerting pharmacists to trivial or nonspecific interactions. 14,16,17 Little information is available about the epidemiology of drug-drug interactions in clinical practice, and most of the evidence is derived from case reports, volunteer studies, or investigations of potential drug-drug interactions in hospitalized patients. [18][19][20][21][22][23] No studies to date have examined clinical outcomes of

Comparative evaluation of three clinical decision support systems: prospective screening for medication errors in 100 medical inpatients

“…Adverse drug events (ADE) are an important cause of morbidity, mortality and increased healthcare costs and therefore a challenging problem for clinical patient care [1][2][3][4][5][6][7]. Drug interactions and dosing errors leading to ADE are of special interest because they represent preventable medication errors that are suitable targets for highly efficient automated interventions through computerized physician order entry (CPOE) with clinical decision support systems (CDSS).…”

A population‐based study of the drug interaction between clopidogrel and angiotensin converting enzyme inhibitors

“…Demographic and mortality data were obtained from the Ontario Health Insurance Plan Registered Persons Database, a registry of all Ontario residents with publically‐funded health insurance, and physicians’ services were identified using OHIP physician claims data. These databases were linked in an anonymous fashion using encrypted Ontario health card numbers, and are routinely used to study drug safety 27, 28, 29, 30, 31, 32.…”

Pharmacy Practice, Research, Education, and Advocacy for Older Adults

“…128 Drug interactions also may contribute to avoidable hospital admissions in older adults. 126 Interactions are most often because of pharmacokinetic or pharmacodynamic properties. Drug interactions resulting in reduced efficacy of drugs might be overlooked more so than those resulting in synergistic effects because other reasons might be used to explain the lack of efficacy (e.g., poor adherence and resistant disease).…”