Prevalence of Polypharmacy and Drug Interaction Among Hospitalized Patients: Opportunities and Responsabilities in Pharmaceutical Care

Abstract

Goal:Polypharmacy and drug-related problems (DRPs) have been shown to prevail in hospitalized patients. We evaluated the prevalence of polypharmacy; and investigated relationship between polypharmacy and: symptoms of DRPs, number of drugs and OTC, index of cumulative morbidity, length of exposure to polypharmacy and the number of days of hospital stay among hospitalized patients.Methodology:A study was performed in Pharmacies „Eufarm Edal“ Tuzla from 2010 to 2011. Polypharmacy was defined as using ≥ 3 drugs. The total study sample of 226 examiners were interviewed with special constructed questionnaires about DRPs. Experimental study group consisted of hospital patients with polypharmacy (n=166) and control group hospital patients without polypharmacy (n=60). Mann-Whitney test was used to test for significant self-reported symptom differences between groups and cross sectional subgroups, t- test and χ2- test for age, gender and treatment data in hospital.Results:The prevalence of polypharmacy was 74% among 226 hospitalized patients. The vulnerable age subgroup of hospitalized patients was men and hospitalized patients aged from 46 to 50 years (not geriatric patients). The prevalence of index of cumulative morbidity was 65%. The most common exposures varied by patient age and by hospital type, with various antibiotics, antidepressants, analgesics, sedatives, antihypertensives, flixotide, ranitidine and others. The prevalence of exposure to OTC and self- treatment was 80%. The prevalence of symptoms of drug-related problems were significantly differed among patients of experimental in relationship of control study group patients (P<0.001).Conclusion:In addition to helping to resolve the above mentioned issues, the results from this study could provide baseline information quantifying the problem of drug- related problems among hospitalized patients receiving polypharmacy and contribute to the formulation and implementation of risk management strategies for pharmacists and physicians in primary care health.

Effects of Polypharmacy on Adverse Drug Reactions among Geriatric outpatients at a Tertiary Care Hospital in Karachi, A prospective cohort study.

“…By 2050, nearly 8 in 10 of the world's older population will be living in the less developed areas [2]. This increase in life expectancy has brought about increased numbers of certain chronic illnesses, which involves hospital admissions, multiple medications and its associated ADR's [3]. Inappropriate use of medicines is one of the challenges of the public health domain and may lead to serious (ADRs) [4]that account for 3% to 23% of hospital admissions, prolong hospital stays, and increase in morbidity and mortality [5].…”

A Prospective Observational Study on Polypharmacy in Geriatrics at A Private Corporate Hospital

“…Over the past 2-3 decades, global health care is facing prominent issues associated with age, comorbidities and polypharmacy. On literature survey related to polypharmacy and its consequences among elderly, it is observed that most of the researches addressed western population (Maher et al, 2014;Nobili et al, 2011;Trumic et al, 2012). Even though few researchers studied polypharmacy among geriatrics in Indian population, the consequences and contributing factors associated with polypharmacy were addressed only in few studies.…”

A Rare Case of Possible, Food, Drug and Acrylamide Pharmacological Interactions

“…The neurological effects described for acrylamide for single oral doses are in the range of 126 mg/kg in rats and rabbits and 100 mg/kg in dogs [4]. In a low-level occupational setting subchronic exposure the prominent neurotoxic effects found for acrylamide include numbness of hands and feet, skeletal muscle weakness and ataxia, and in an experimental setting acrylamide intoxication consisted of neurogenic autonomic dysfunction such as urinary retention, impaired vasomotor control and baroreceptor dysfunction [9].…”

“…In a low-level occupational setting subchronic exposure the prominent neurotoxic effects found for acrylamide include numbness of hands and feet, skeletal muscle weakness and ataxia, and in an experimental setting acrylamide intoxication consisted of neurogenic autonomic dysfunction such as urinary retention, impaired vasomotor control and baroreceptor dysfunction [9]. Some other studies concluded in order to obtain clinical effect lower doses need to accumulate [4].…”

“…The pharmacotherapy for such disorder usually starts with one single drug and during the course of the treatment it might become necessary to escalate not only dosing but onto other drugs, in doing this, the chances of drug-drug interaction increase [3,4]. For example a patient may receive cyclobenzaprine, paracetamol+caffeine, the first one as a relaxant and the second to clearly mitigate the pain.…”