对一家三级护理医院中开具给老年患者的药物之间潜在药物相互作用的评估。
Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital.
作者信息
Shetty Varsha, Chowta Mukta N, Chowta K Nithyananda, Shenoy Ashok, Kamath Ashwin, Kamath Priyanka
机构信息
Department of Medicine and Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India.
出版信息
J Aging Res. 2018 Oct 9;2018:5728957. doi: 10.1155/2018/5728957. eCollection 2018.
BACKGROUND AND OBJECTIVES
The drugs most commonly implicated in major potential interactions are those used in the day-to-day clinical management of elderly patients with chronic diseases. This study is planned to evaluate the profile of drug-drug interactions in the medications prescribed to elderly population and also to identify the possible predictors for potential drug-drug interactions in the elderly.
METHODS
This cross-sectional study included patients aged above 60 years with a minimum of two drugs in the prescriptions. Data were collected from medical prescriptions and patients' medical records. The data collected included demographic characteristics such as age, gender, height, weight, educational status, socioeconomic status, medical history, and medications prescribed. The prescriptions were analyzed for the potential drug interactions using Lexi-Interact™ Online, an online software to check drug-drug interactions.
RESULTS
A total of 209 patients were included in the study, among them 104 (49.8%) were males and 105 (50.2%) were females. The mean number of medications received was 6.53 ± 2.15 per prescription. Around 138 (66%) patients received more than six medications. The mean number of potential drug interactions seen in the prescription of these patients was 3.17 ± 2.78. Around 18.2% patients had more than five drug interactions. Major drug interactions were observed in 21.42% of cases. Around 3.02% of drug interactions belonged to risk category X, i.e., to be avoided. Logistic regression analysis showed that age above 70 years was associated with the presence of drug interactions. Increased number of medication was independently associated with the occurrence of drug interactions. The presence of drug interactions was not associated with increased number of comorbidities.
CONCLUSION
A significant number of potential drug-drug interactions were seen in the prescriptions of elderly patients. Increasing age and polypharmacy were identified as the predictors of potential drug interactions.
背景与目的
在日常临床治疗中，常用于老年慢性病患者管理的药物最常涉及重大潜在相互作用。本研究旨在评估老年人群所开药物中的药物相互作用情况，并确定老年人潜在药物相互作用的可能预测因素。
方法
这项横断面研究纳入了60岁以上且处方中至少使用两种药物的患者。数据从医疗处方和患者病历中收集。收集的数据包括年龄、性别、身高、体重、教育程度、社会经济状况、病史以及所开药物等人口统计学特征。使用Lexi-Interact™ Online（一款用于检查药物相互作用的在线软件）分析处方中的潜在药物相互作用。
结果
本研究共纳入209例患者，其中男性104例（49.8%），女性105例（50.2%）。每张处方平均用药数量为6.53±2.15种。约138例（66%）患者用药超过6种。这些患者处方中潜在药物相互作用的平均数量为3.17±2.78种。约18.2%的患者药物相互作用超过5种。21.42%的病例观察到主要药物相互作用。约3.02%的药物相互作用属于X类风险，即应避免使用。逻辑回归分析表明，70岁以上年龄与药物相互作用的存在相关。用药数量增加与药物相互作用的发生独立相关。药物相互作用的存在与合并症数量增加无关。
结论
在老年患者的处方中发现了大量潜在的药物相互作用。年龄增长和多药联用被确定为潜在药物相互作用的预测因素。
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