Polypharmacy and potential drug–drug interactions in emergency department patients in the Caribbean

Dookeeram, Darren; Bidaisee, Satesh; Paul, Joanne; Nunes, Paula; Robertson, Paul L.; Maharaj, Vidya Ramcharitar; Sammy, Ian

doi:10.1007/s11096-017-0520-9

Cited by 44 publications

(50 citation statements)

References 14 publications

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“…[44][45][46] As well as medication discrepancies, potential drugdrug interactions were more frequent at admission to the hospital, as 78.7% of the study sample had at least 1 potential drug-drug interaction, with a significant difference of 8.2% in the distribution of patients with potential drug-drug interactions, from the patient's admission to the discharge time. In contrast to previous studies, 47,48 our data suggest a reduction in potential drug-drug interactions even though there was an increase in polypharmacy prevalence at discharge time. The absence of this association may be due to the small sample size, the different population of the study, or the different study setting.…”

Section: Discussioncontrasting

confidence: 99%

Measures of Drug Prescribing at Care Transitions in an Internal Medicine Unit

Colombo

Nunnari

Ceccarelli³

et al. 2018

The Journal of Clinical Pharma

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Care transitions represent a common source of drug errors and confusions. The purpose of our prospective observational study was to assess the prevalence of medication discrepancies at care transitions, along with potentially inappropriate medications and potential drug-drug interactions, in an internal medicine unit of an Italian hospital. Adverse drug reactions that occurred in the 30-day period after the discharge from the hospital were included. A related-samples McNemar test was performed for evaluating the effects of hospitalization on the above-mentioned measures of drug prescribing. Medication discrepancies were frequent both on admission (93.4% [95%CI 0.8749, 0.9713]) and at discharge (78.7% [95%CI 0.7035, 0.8558]), with a significant difference between transition times (-14.7% [95%CI -21.82%, -7.69%]; P < .001)]. A high potentially inappropriate medication use prevalence was revealed without differences between care transitions. Potential drug-drug interactions were more frequent at admission to the hospital, with a significant difference of 8.2% in the distribution of patients with potential drug-drug interactions between care transitions. None of the adverse drug reactions recorded on follow-up was related to unintentional discrepancies, and the prevalence rate of patients with potentially inappropriate medication-related adverse drug reactions ranged between 4.9% and 6.9%, and the prevalence rate of patients with drug-drug interaction-related adverse drug reactions was 4.1% of patients. This study is important to raise awareness of the potential dangers medication discrepancies, potentially inappropriate medications, and potential drug-drug interactions could have on older adults. Clinicians and clinical pharmacologists must collaborate to improve patient care and minimize drug-related clinical outcomes.

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Section: Discussioncontrasting

confidence: 99%

Measures of Drug Prescribing at Care Transitions in an Internal Medicine Unit

Colombo

Nunnari

Ceccarelli³

et al. 2018

The Journal of Clinical Pharma

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“…For example it was reported that women had a lower probability of having potentially serious DDIs (type D), which should be avoided, than men, while another study found that female gender was positively associated with pDDI [2,30]. Other studies in accordance with this study, found no association between pDDI and gender [31,32]. These contradicting finding maybe attributed to differences in the methodologies of the studies.…”

Section: Association With Gendermentioning

confidence: 44%

The prevalence of drug-drug interactions and polypharmacy among elderly patients in Jordan

Al‐Qerem¹,

Jarrar²,

Al-Sheikh³

et al. 2018

biomedicalresearch

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Background: The number of people aged 60 or older is estimated to be 5.6% among Jordanian population, those elderly people need special medical care; since they have a greater prevalence of chronic diseases and therefore subjected to higher prevalence of polypharmacy and potential drug-drug interaction (pDDI). There is no data about polypharmacy and pDDI in elderly patients among the Jordanian population. Methods: Prescriptions for patients aged 60 or older were examined and those patients were interviewed in several community pharmacies and hospitals' outpatient pharmacies. The interviews covered factors that may affect the possibility of pDDI and polypharmacy including patient's education level, number of doctors the patient see, number of drugs the patient take, does the patient live alone and does the patient take the medication by himself. Results: 367 (51.5% male and 48.5% female) patients were interviewed and their prescriptions examined. The data showed that 334 (91%) had at least one pDDI of those 67 (18.3%) had a major pDDI and 281 (76.6%) had at least one moderate pDDI. Polypharmacy was found in 275 (74.9%) of the participants. Factors that were associated with incidence of major pDDI included polypharmacy, taking Alimentary tract and metabolism drugs or drugs acting on blood and blood forming organ, and patient taking medication by him/herself. Several factors were associated with moderate pDDI including seeing a general practitioner, while polypharmacy was associated with education level and number of diseases. Conclusion: High incidence of major and moderate pDDI and polypharmacy was found. This study emphasizes the need for a better control over elderly prescription in Jordan

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“…Polypharmacy increases the risk of a wide range of undesirable health outcomes and events such as adverse drug events and drug-drug interactions [4,5]. Polypharmacy is associated with reduced medication adherence [6][7][8][9] and an increase in potentially inappropriate medication (PIM) use [10].…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

et al. 2020

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Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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Polypharmacy and potential drug–drug interactions in emergency department patients in the Caribbean

Cited by 44 publications

References 14 publications

Measures of Drug Prescribing at Care Transitions in an Internal Medicine Unit

Measures of Drug Prescribing at Care Transitions in an Internal Medicine Unit

The prevalence of drug-drug interactions and polypharmacy among elderly patients in Jordan

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

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