Teramura-Grönblad Mariko, Raivio Minna, Savikko Niina, Muurinen Seija, Soini Helena, Suominen Merja, Pitkälä Kaisu
a Home Care , City of Helsinki , Finland ;
b University of Helsinki, Department of General Practice and Helsinki University Hospital , Unit of Primary Health Care , Finland ;
Scand J Prim Health Care. 2016 Sep;34(3):250-7. doi: 10.1080/02813432.2016.1207142. Epub 2016 Jul 18.
This study aims to assess potentially severe class D drug-drug interactions (DDDIs) in residents 65 years or older in assisted living facilities with the use of a Swedish and Finnish drug-drug interaction database (SFINX).
A cross-sectional study of residents in assisted living facilities in Helsinki, Finland.
A total of 1327 residents were assessed in this study. Drugs were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and DDDIs were coded according to the SFINX.
Prevalence of DDDIs, associated factors and 3-year mortality among residents.
Of the participants (mean age was 82.7 years, 78.3% were females), 5.9% (N = 78) are at risk for DDDIs, with a total of 86 interactions. Participants with DDDIs had been prescribed a higher number of drugs (10.8 (SD 3.8) vs. 7.9 (SD 3.7), p < 0.001). A larger proportion of residents with DDDIs suffered from rheumatoid arthritis or osteoarthritis than those not exposed to DDDIs (24.7% vs. 15.4%, p = 0.030). The most frequent DDDIs were related to the concomitant use of potassium with amiloride (N = 12) or spironolactone (N = 12). Carbamazepine (N = 13) and methotrexate (N = 9) treatments were also frequently linked to DDDIs. During the follow-up, no differences in mortality emerged between the participants exposed to DDDIs and the participants not exposed to DDDIs.
Of the residents in assisted living, 5.9% were exposed to DDDIs associated with the use of a higher number of drugs. Physicians should be trained to find safer alternatives to drugs associated with DDDIs. KEY POINTS Potentially severe, class D drug-drug interactions (DDDIs) have been defined in the SFINX database as clinically relevant drug interactions that should be avoided. • Of the residents in assisted living, 5.9% were exposed to DDDIs that were associated with the use of a higher number of drugs. • The most frequent DDDIs were related to the concomitant use of potassium with amiloride or spironolactone. Carbamazepine and methotrexate were also linked to DDDIs. • No difference in mortality was observed between residents exposed to DDDIs and residents not exposed to DDDIs.
本研究旨在利用瑞典和芬兰药物相互作用数据库（SFINX）评估65岁及以上生活辅助设施居民中潜在的严重D级药物相互作用（DDDI）。
对芬兰赫尔辛基生活辅助设施居民进行的横断面研究。
本研究共评估了1327名居民。药物根据解剖治疗化学（ATC）分类系统进行分类，DDDI根据SFINX进行编码。
居民中DDDI的患病率、相关因素及3年死亡率。
参与者（平均年龄82.7岁，78.3%为女性）中，5.9%（N = 78）有发生DDDI的风险，共有86种相互作用。发生DDDI的参与者所服用药物数量更多（10.8（标准差3.8）对7.9（标准差3.7），p < 0.001）。与未暴露于DDDI的居民相比，发生DDDI的居民中患类风湿性关节炎或骨关节炎的比例更高（24.7%对15.4%，p = 0.030）。最常见的DDDI与钾与阿米洛利（N = 12）或螺内酯（N = 12）的同时使用有关。卡马西平（N = 13）和甲氨蝶呤（N = 9）治疗也经常与DDDI相关。在随访期间，暴露于DDDI的参与者和未暴露于DDDI的参与者之间死亡率无差异。
在生活辅助设施居民中，5.9%暴露于与更多药物使用相关的DDDI。应培训医生寻找与DDDI相关药物的更安全替代药物。要点：SFINX数据库将潜在的严重D级药物相互作用（DDDI）定义为应避免的临床相关药物相互作用。
• 在生活辅助设施居民中，5.9%暴露于与更多药物使用相关的DDDI。
• 最常见的DDDI与钾与阿米洛利或螺内酯的同时使用有关。卡马西平和甲氨蝶呤也与DDDI相关。
• 暴露于DDDI的居民和未暴露于DDDI的居民之间未观察到死亡率差异。
