Potential drug–drug interactions in hospitalised haematological patients

Abstract

Background Frequently, haematological patients undergo highly complex and intensive treatment protocols, so a high risk of drug-drug interactions could be expected. Objectives To determine prevalence of clinically relevant drug-drug interactions, to identify the most frequent drug-drug interactions and associated risk factors. Methods A prospective, observational and descriptive study was carried out from November 2012 to February 2013. Twice a week, every patient's treatment sheet was collected. Each medication list was screened through two databases: Thomson MicromedexTM and Drug Interaction FactsTM. All identified potential drug-drug interactions with a moderate or higher severity rating were recorded. Summary statistics were used to describe patient and disease characteristics, most often prescribed drugs, and frequency, types and classification of drug-drug interactions. Multiple logistic regression models were used to identify risk factors associated with drug-drug interactions. Results A total of 2061 drug-drug interactions were detected in 317 treatment sheets from 58 patients. The prevalence of treatment sheets with drug-drug interactions by Micromedex and Drug Interaction Facts databases were 74.1% and 56.8%, respectively. Azole antifungals, immunosuppressive drugs, antiemetics, antidepressants, acid suppressants and corticosteroids were the most frequent involved drugs. In multivariate analysis, the main risk factor associated with increased odds for drug-drug interactions was a higher number of non-antineoplastic drugs. Conclusions The prevalence of drug-drug interactions was common, with immunosuppressant and azole antifungal agents being the most commonly involved drugs. The factor having the greatest influence on drug-drug interactions was a higher number of non-antineoplastic drugs.

Assessment of Physician's Knowledge of Potential Drug-Drug Interactions: An Online Survey in China

“…The potential drug-drug interactions (PDDIs) were identified in around 30% of the prescriptions in the outpatient (6) and oncology departments in China (6,7). Even though the prevalence data is largely lacking in China, the PDDIs may be more prevalent in intensive care settings (8) and hematology (9,10), based on the data from other countries. Patients experienced a PDDI are generally associated with a longer hospital stay (11) and higher medical costs (12,13), leading to substantial financial burden on healthcare systems as well as on patients and society (14).…”

Prevalence of potential drug–drug interactions in outpatients of a general hospital in China: a retrospective investigation

“…DDIs are highly prevalent not only in outpatients but also in hospitalized patients especially in ICU [6,7], oncology [8][9][10] and hematology [11,12]. The prevalence of pDDIs varies from 16% to 96% in different studies [13][14][15][16].…”

Isavuconazole for COVID-19-Associated Invasive Mold Infections

“…On the contrary, with wild type isolates, even with the MIC of 2 mg/L, high doses of isavuconazole might still be effective [ 28 ]. However, obtaining adequate plasma levels is required, since ICU patients receive frequently not only other drugs that may potentially have drug–drug interactions with azoles, but also undergo renal replacement therapy or extracorporeal membrane oxygenation (ECMO) which have been associated with a higher probability of subtherapeutic levels of azoles [ 71 ]. Therefore, even though TDM of isavuconazole is generally not recommended, the CAPA-specific guidelines recommended TDM of isavuconazole in selected cases [ 72 ].…”