Schröder Sebastian, Westhoff Martin Schulze, Pfister Tabea, Seifert Johanna, Bleich Stefan, Koop Felix, Proskynitopoulos Phileas Johannes, Glahn Alexander, Heck Johannes
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
Ther Adv Psychopharmacol. 2024 Feb 21;14:20451253241232563. doi: 10.1177/20451253241232563. eCollection 2024.
Older patients with alcohol use disorder are at particular risk of developing adverse drug reactions due to multimorbidity, polypharmacy, and altered organ function.
In this study, we investigated the frequency and characteristics of potentially serious alcohol-medication interactions, potentially inappropriate medications (PIMs) for older adults, and potential drug-drug interactions (pDDIs) in a population of older patients with alcohol use disorder over a 10-year period.
Retrospective monocentric cohort study.
Prescribed medications were screened for potentially serious alcohol-medication interactions, PIMs, and pDDIs using the POSAMINO (POtentially Serious Alcohol-Medication INteractions in Older adults) criteria, the PRISCUS 2.0 list, the FORTA (Fit fOR The Aged) classification, and the drug interaction program AiD.
We enrolled 114 patients aged ⩾65 years with alcohol use disorder, who were treated in an addiction unit of a university hospital in Germany. About 80.7% of the study population had at least one potentially serious alcohol-medication interaction. Potentially serious alcohol-medication interactions most commonly affected the cardiovascular (57.7%) and the central nervous system (32.3%). A total of 71.1% of the study population received at least one prescription of a FORTA C or D drug, compared with 42.1% who received at least one PIM prescription according to the PRISCUS 2.0 list. A total of 113 moderate and 72 severe pDDIs were identified in the study population.
Older patients with alcohol use disorders are frequently exposed to potentially serious alcohol-medication interactions, PIMs, and pDDIs. Improvements in the quality of prescribing should primarily target the use of cardiovascular and psychotropic drugs.
患有酒精使用障碍的老年患者由于存在多种疾病、使用多种药物以及器官功能改变，发生药物不良反应的风险尤其高。
在本研究中，我们调查了10年间患有酒精使用障碍的老年患者群体中潜在严重酒精与药物相互作用、老年人潜在不适当用药（PIMs）以及潜在药物相互作用（pDDIs）的发生频率和特征。
回顾性单中心队列研究。
使用POSAMINO（老年人潜在严重酒精与药物相互作用）标准、PRISCUS 2.0清单、FORTA（适合老年人）分类以及药物相互作用程序AiD，对所开具的药物进行潜在严重酒精与药物相互作用、PIMs和pDDIs筛查。
我们纳入了114名年龄≥65岁且患有酒精使用障碍的患者，这些患者在德国一家大学医院的成瘾科接受治疗。约80.7%的研究人群至少存在一种潜在严重酒精与药物相互作用。潜在严重酒精与药物相互作用最常影响心血管系统（57.7%）和中枢神经系统（32.3%）。根据FORTA C或D类药物标准，71.1%的研究人群至少接受过一次此类药物处方，而根据PRISCUS 2.0清单，42.1%的研究人群至少接受过一次PIM处方。在研究人群中总共识别出113例中度和72例重度pDDIs。
患有酒精使用障碍的老年患者经常面临潜在严重酒精与药物相互作用、PIMs和pDDIs。处方质量的改善应主要针对心血管药物和精神药物的使用。
