Drug–drug interactions in a cohort of hospitalized elderly patients

Pasina, Luca; Djade, Codjo D.; Nobili, Alessandro; Tettamanti, Mauro; Franchi, Carlotta; Salerno, Francesco; Corrao, Salvatore; Marengoni, Alessandra; Iorio, Alfonso; Marcucci, Maura; Mannucci, Pier Mannuccio

doi:10.1002/pds.3510

Cited by 54 publications

(55 citation statements)

References 34 publications

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“…In this study, 62.2 % of the respondents were exposed to at least one potential DDI [including contraindicated (3.6 %), major (32.9 %) and moderate (25.7 %)]. The prevalence of major and moderate DDI in the current study is in line with the findings by Luca et al [31] and Lea et al [32], which reported a prevalence of 63.5, 60.5 % potential DDIs respectively. In contrast to this study, lower prevalence of DDIs was reported from other studies focusing on elderly outpatients [33–35].…”

Section: Discussionsupporting

confidence: 93%

Potential drug–drug interactions among elderly patients admitted to medical ward of Ayder Referral Hospital, Northern Ethiopia: a cross sectional study

et al. 2016

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BackgroundThe elderly are considered as special population, as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics, vulnerability to drug–drug interactions and adverse drug reactions. Despite the fact that the elderly patients are at high risk of having drug interaction and potential adverse outcomes, studies in this regard are scarce in resource limited settings like Ethiopia. The aim of this study was to assess the prevalence and determinants of potential drug–drug interaction in elderly patients admitted to medical ward of Ayder Referral Hospital in Northern Ethiopia.MethodsA cross sectional study was conducted among elderly inpatients aged 60 years and above. The study was conducted from February to May 2014. Prescribed drugs being taken concurrently for at least 24 h were included and checked for drug–drug interaction using Micromedex® 2.0 online drug reference. Data were analyzed using statistical software, statistical package for social sciences for windows version 20. Logistic regression model was used to analyze factors associated with occurrence of drug interaction. P value of <0.05 was considered statistically significant.ResultsA total of 140 patients were participated in the study. The mean age (±standard deviation) of participants was 68 (±7) years. Majority (61.4 %) of patients were diagnosed with cardiovascular and/or renal diseases. A total of 814 drugs were prescribed with a mean of 6 (±4) medications per patient during a 13 (±9) days of hospital stay. About two-third (62.2 %) of the respondents were exposed to at least one potential drug–drug interaction. Among these 3.6, 32.9 and 25.7 % of patients had taken contraindicated drug combination, at least one major and at least one moderate drug–drug interaction, respectively. Patients with five or more prescribed medications were four times at risk of having drug–drug interaction (P = 0.00; adjusted odds ratio 4.047; 95 % confidence interval 1.867–8.775).ConclusionDrug–drug interaction in elderly patients was common in this resource limited set-up. Awareness creation and clinical pharmacist involvement in minimizing the risk associated with potentially harmful drug combinations are needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2238-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Potential drug–drug interactions among elderly patients admitted to medical ward of Ayder Referral Hospital, Northern Ethiopia: a cross sectional study

et al. 2016

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“…A study of more than 2,000 elderly Italian adults at hospital discharge found that almost 70% were exposed to at least one drug-drug interaction and approximately 24% were exposed to a potentially severe interaction. 45 Here, important interactions with four agents or classes (statins, factor Xa inhibitors such as apixaban and rivaroxaban, warfarin, and calcium channel blockers) are briefly reviewed ( Table 2).…”

Section: Important Drug-drug Interactions In Older Adults In Primary mentioning

confidence: 99%

Common Drug Side Effects and Drug‐Drug Interactions in Elderly Adults in Primary Care

Merel

Paauw

2017

J American Geriatrics Society

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Prescribing medications, recognizing and managing medication side effects and drug interactions, and avoiding polypharmacy are all essential skills in the care of older adults in primary care. Important side effects of medications commonly prescribed in older adults (statins, proton pump inhibitors, trimethoprim-sulfamethoxazole and fluoroquinolone antibiotics, zolpidem, nonsteroidal antiinflammatory drugs, selective serotonin reuptake inhibitors, dipeptidyl peptidase 4 inhibitors) were reviewed. Important drug interactions with four agents or classes (statins, warfarin, factor Xa inhibitors, and calcium channel blockers) are discussed.

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“…One case of death was classified as potentially related to a PIM listed in both versions of Beers' criteria at the 3‐month follow‐up, although associated to a severe DDI. In a recent study conducted on the same cohort of patients and focused on DDIs and related risk of adverse outcomes, we found that five patients were re‐admitted within 3 months after discharge for a severe DDI. In all these cases, patients were not receiving PIMs.…”

Section: Discussionmentioning

confidence: 89%

Prevalence of potentially inappropriate medications and risk of adverse clinical outcome in a cohort of hospitalized elderly patients: results from the REPOSI Study

et al. 2014

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This study found no significant effect of inappropriate drug use according to Beers' criteria on health outcomes among older adults 3 month after discharge. Even though these criteria have been suggested as helpful in promoting appropriate prescribing, reducing drug-related adverse events and associated healthcare costs, to date there is no clear evidence that their application can achieve objective and quantifiable improvements in clinical outcomes. A possible explanation is that both versions of the Beers' criteria have several recognized limitations, one of the main ones being the restricted availability of some drugs in Europe or their limited prescription in everyday clinical practice.

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Drug–drug interactions in a cohort of hospitalized elderly patients

Cited by 54 publications

References 34 publications

Potential drug–drug interactions among elderly patients admitted to medical ward of Ayder Referral Hospital, Northern Ethiopia: a cross sectional study

Potential drug–drug interactions among elderly patients admitted to medical ward of Ayder Referral Hospital, Northern Ethiopia: a cross sectional study

Common Drug Side Effects and Drug‐Drug Interactions in Elderly Adults in Primary Care

Prevalence of potentially inappropriate medications and risk of adverse clinical outcome in a cohort of hospitalized elderly patients: results from the REPOSI Study

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