Rashid Khalid, Khan Yahya, Ansar Farrukh, Waheed Aamir, Aizaz Muhammad
Internal Medicine, James Cook University Hospital, Middlesbrough, GBR.
Department of Medical Education, Pak International Medical College, Peshawar, PAK.
Cureus. 2021 Aug 20;13(8):e17336. doi: 10.7759/cureus.17336. eCollection 2021 Aug.
Introduction Adverse events related to Drug-Drug Interactions (DDIs) are among the few common reasons for hospitalization worldwide; however, they can be prevented with an efficient patient-centered system. Different mechanisms have successfully limited the prevalence of DDIs in developed countries. There are limited data regarding DDIs from limited-resource settings. Furthermore, there is no cost-effective system that has shown promising results in preventing them in this setting. This study aims to assess the frequency of potential DDIs in a low-resource setting and to check its association with different factors such as poly-pharmacy and demographics. Methods Through this cross-sectional study, drug charts of patients admitted to a medical unit in November 2019 were analyzed using a structured questionnaire. A list of drugs co-prescribed to each patient was entered into the Medscape Drug Interaction checker to calculate the frequency and severity of potential DDIs. Results The mean age of patients was 49 years, and on average, seven drugs were prescribed to each patient. Among 100 analyzed prescriptions, 400 potential DDIs were identified with a mean of 4±5.42 per patient. According to Medscape interaction checker classification, 2 DDIs were contraindicated, 28 were serious, 246 required close monitoring, and 124 were minor. The most frequently encountered drug interaction was "spironolactone with furosemide." There was a significant correlation of the occurrence of potential DDIs with increased numbers of prescribed drugs. Conclusion Our patient population was prescribed more drugs per patient than calculated in other settings. Poly-pharmacy is an independent risk factor for DDIs. Lastly, advancing age exposes patients to poly-pharmacy, and therefore, they are at a higher risk of developing DDIs.
与药物相互作用(DDIs)相关的不良事件是全球范围内导致住院的少数常见原因之一;然而,通过高效的以患者为中心的系统可以预防这些事件。不同机制已成功降低了发达国家中药物相互作用的发生率。来自资源有限地区的药物相互作用数据有限。此外,在这种情况下,尚无显示出有预防效果的具有成本效益的系统。本研究旨在评估资源匮乏地区潜在药物相互作用的发生频率,并检查其与多药联用和人口统计学等不同因素的关联。方法:通过这项横断面研究,使用结构化问卷对2019年11月入住内科病房的患者的药物图表进行分析。将每位患者同时开具的药物清单输入Medscape药物相互作用检查器,以计算潜在药物相互作用的频率和严重程度。结果:患者的平均年龄为49岁,每位患者平均开具七种药物。在100份分析的处方中,共识别出400种潜在药物相互作用,每位患者平均有4±5.42种。根据Medscape相互作用检查器的分类,2种药物相互作用为禁忌,28种为严重,246种需要密切监测,124种为轻微。最常遇到的药物相互作用是“螺内酯与呋塞米”。潜在药物相互作用的发生与开具药物数量的增加存在显著相关性。结论:我们的患者群体每位患者开具的药物比其他环境中计算的更多。多药联用是药物相互作用的独立危险因素。最后,年龄增长使患者面临多药联用的风险,因此,他们发生药物相互作用的风险更高。