Becker Matthijs L, Kallewaard Marjon, Caspers Peter W J, Visser Loes E, Leufkens Hubert G M, Stricker Bruno H Ch
Pharmaco-epidemiology Unit, Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Pharmacoepidemiol Drug Saf. 2007 Jun;16(6):641-51. doi: 10.1002/pds.1351.
Our objective was to evaluate the incidence of adverse patient outcomes due to drug-drug interactions (D-DIs), the type of drugs involved and the underlying reason. As a proxy for adverse patient outcomes, emergency department (ED) visits, hospital admissions and re-hospitalisations were assessed.
A literature search in the Medline and Embase database (1990-2006) was performed and references were tracked. An overall cumulative incidence was estimated by dividing the sum of the cases by the sum of the study populations.
Twenty-three studies were found assessing the relationship between D-DIs and ED-visits, hospitalisations or re-hospitalisations. The studies with a large study size showed low incidences and vice versa. D-DIs were held responsible for 0.054% of the ED-visits, 0.57% of the hospital admissions and 0.12% of the re-hospitalisations. In the elderly population, D-DIs were held responsible for 4.8% of the admissions. Drugs most often involved were NSAIDs and cardiovascular drugs. The reasons for admissions or ED-visits, which were most often found were GI-tract bleeding, hyper- or hypotension and cardiac rhythm disturbances.
This review provides information on the overall incidence of D-DIs as a cause of adverse patient outcomes, although there is still uncertainty about the impact of D-DIs on adverse patient outcomes. Our results suggest that a limited number of drugs are involved in the majority of cases and that the number of reasons for admission as a consequence of D-DIs seems to be modest.
我们的目标是评估因药物相互作用（D-DIs）导致的不良患者结局的发生率、所涉及的药物类型以及潜在原因。作为不良患者结局的替代指标，我们评估了急诊科就诊、住院和再次住院情况。
在Medline和Embase数据库（1990 - 2006年）中进行文献检索并追踪参考文献。通过将病例总和除以研究人群总和来估计总体累积发生率。
共找到23项评估D-DIs与急诊科就诊、住院或再次住院之间关系的研究。研究规模大的研究显示发生率较低，反之亦然。D-DIs导致的急诊科就诊占0.054%，住院占0.57%，再次住院占0.12%。在老年人群中，D-DIs导致的住院占4.8%。最常涉及的药物是非甾体抗炎药（NSAIDs）和心血管药物。最常见的住院或急诊科就诊原因是胃肠道出血、高血压或低血压以及心律失常。
本综述提供了关于D-DIs作为不良患者结局原因的总体发生率的信息，尽管D-DIs对不良患者结局的影响仍存在不确定性。我们的结果表明，大多数情况下涉及的药物数量有限，且因D-DIs导致的住院原因数量似乎不多。
