Chatsisvili Anna, Sapounidis Ioakeim, Pavlidou Georgia, Zoumpouridou Eudoxia, Karakousis Vasileios-Alexandros, Spanakis Marios, Teperikidis Lefteris, Niopas Ioannis
Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
Pharm World Sci. 2010 Apr;32(2):187-93. doi: 10.1007/s11096-010-9365-1. Epub 2010 Jan 14.
To evaluate the nature, type and prevalence of potential drug-drug interactions (DDIs) in prescriptions dispensed in community pharmacies in Thessaloniki, Greece. Secondary objectives included the classification of DDIs as per pharmacotherapeutic class of the medications and the investigation of the relationship between medical specialties and the frequency of potential DDIs, as well as the relationship between DDIs and prescription size. Setting DDIs are a common cause of adverse drug reactions (ADRs) among patients using multiple drug therapy. In Greece a reliable computerized surveillance system for monitoring potential DDIs is not yet fully established. As a result, the prevalence of such DDIs in prescriptions dispensed by community pharmacies in Greece is unknown.
We conducted a prospective, descriptive study. Over a 3-month period (November 2007-January 2008), a total of 1,553 handwritten prescriptions were collected from three community pharmacies in Thessaloniki, Greece. The prescriptions were processed using the Drug Interactions Checker within the www.drugs.com database. The identified potential DDIs were categorized into two classes, major and moderate, according to their level of clinical significance.
Overall 213 prescriptions had one or more potential DDIs and a total of 287 major and moderate DDIs were identified. Potential DDIs were identified in 18.5% of all prescriptions. Major DDIs were identified in 1.9% of all prescriptions and represented 10.5% of all DDIs detected, whereas moderate DDIs were identified in 16.6% of all prescriptions and represented 89.5% of all DDIs detected. The rate of DDIs increased with prescription size. The most common drug involved in major DDIs was amiodarone which interacts with potassium-wasting diuretics, digoxin, simvastatin and acenocoumarol.
Our results indicate that patients in Greece are at risk of ADRs caused by medications due to potential DDIs. An appropriate surveillance system for monitoring such interactions should be implemented and physicians should be more aware of potentially harmful DDIs. Pharmacists can contribute to the detection and prevention of drug-related injuries, especially of clinically meaningful DDIs that pose a potential risk to patient safety.
评估希腊塞萨洛尼基社区药房所配处方中潜在药物相互作用（DDIs）的性质、类型及发生率。次要目标包括根据药物的药物治疗类别对DDIs进行分类，研究医学专科与潜在DDIs发生频率之间的关系，以及DDIs与处方量之间的关系。背景 DDIs是接受多种药物治疗的患者发生药物不良反应（ADR）的常见原因。在希腊，用于监测潜在DDIs的可靠计算机化监测系统尚未完全建立。因此，希腊社区药房所配处方中此类DDIs的发生率尚不清楚。
我们开展了一项前瞻性描述性研究。在2007年11月至2008年1月的3个月期间，从希腊塞萨洛尼基的三家社区药房共收集了1553份手写处方。使用www.drugs.com数据库中的药物相互作用检查器对这些处方进行处理。根据其临床意义水平，将识别出的潜在DDIs分为两类，即严重和中度。
共有213份处方存在一种或多种潜在DDIs，共识别出287例严重和中度DDIs。在所有处方中，18.5%存在潜在DDIs。严重DDIs在所有处方中占1.9%，占所有检测到的DDIs的10.5%，而中度DDIs在所有处方中占16.6%，占所有检测到的DDIs的89.5%。DDIs的发生率随处方量增加而升高。涉及严重DDIs最常见的药物是胺碘酮，它与排钾利尿剂、地高辛、辛伐他汀和醋硝香豆素相互作用。
我们的结果表明，由于潜在的DDIs，希腊患者有因药物导致ADR的风险。应实施适当的监测系统来监测此类相互作用，医生应更加了解潜在有害的DDIs。药剂师可以在发现和预防药物相关伤害方面发挥作用，特别是对患者安全构成潜在风险的具有临床意义的DDIs。
