Radosević Nives, Gantumur Monja, Vlahović-Palcevski Vera
Department of Pharmacology, University of Rijeka Medical School, Rijeka, Croatia.
Pharmacoepidemiol Drug Saf. 2008 Jul;17(7):733-7. doi: 10.1002/pds.1531.
The objective of this study was to evaluate the prevalence of potential drug-drug interactions (DDIs) in hospitalised patients in correlation with patient's age and number of drugs prescribed and to determine the prevalence of inappropriate drugs prescribed to elderly patients.
Drugs prescribed during 1 day to all hospitalised patients at seven wards of Department of Medicine in University Hospital Rijeka were recorded by reviewing patient medical charts. Potential DDIs were evaluated using a list of potentially harmful drug combinations compiled from the literature. Beers criteria were used to identify potentially inappropriate medications in patients aged 65 years or older.
The study included 225 patients that received a total of 1301 drugs. Twenty-two percent of the patients receiving drug therapy were prescribed drug combinations that are potentially harmful. The most common potentially harmful drug combination was an ACE inhibitor with a potassium supplement (33.9% of all combinations). In the multivariate analysis, age and number of drugs are significantly associated with potential DDIs (r = 0.8629). One quarter of elderly patients received a drug potentially inappropriate considering their age. The most commonly prescribed potentially inappropriate drug was amiodarone, followed by diazepam.
Polypharmacy and older age have been proven to be important risk factors for potential drug interactions. We identified a high rate of prescribing potentially inappropriate medications among elders. Results of this study indicate that particular caution should be given when prescribing drugs to patients already receiving drugs and to elderly patients, considering the risk of drug-related problems.
本研究的目的是评估住院患者中潜在药物相互作用（DDIs）的发生率，并将其与患者年龄及所开药物数量相关联，同时确定老年患者中开具不适当药物的发生率。
通过查阅患者病历，记录里耶卡大学医院内科七个病房所有住院患者一天内所开的药物。使用从文献中汇编的潜在有害药物组合清单评估潜在的药物相互作用。采用Beers标准识别65岁及以上患者中潜在不适当的药物。
该研究纳入了225名患者，共开具了1301种药物。接受药物治疗的患者中有22%被开具了潜在有害的药物组合。最常见的潜在有害药物组合是血管紧张素转换酶（ACE）抑制剂与补钾剂（占所有组合的33.9%）。在多变量分析中，年龄和药物数量与潜在药物相互作用显著相关（r = 0.8629）。四分之一的老年患者接受了考虑其年龄可能不适当的药物。最常开具的潜在不适当药物是胺碘酮，其次是地西泮。
已证明多药合用和高龄是潜在药物相互作用的重要危险因素。我们发现老年人中开具潜在不适当药物的比例很高。本研究结果表明，考虑到药物相关问题的风险，在给已经在用药的患者和老年患者开药时应格外谨慎。
