Özaydın Fuat Nihat, Özaydın Ayşe Nilüfer
Pharmacology Department, Istanbul Atlas University Faculty of Medicine, Istanbul, Turkiye.
Public Health Department, Marmara University Faculty of Medicine, Istanbul, Turkiye.
PeerJ. 2025 Feb 25;13:e19032. doi: 10.7717/peerj.19032. eCollection 2025.
The risk of potential drug‒drug interactions is highest in oldest-old people. Thus, the aim of this study was to investigate the frequency and type of potential drug‒drug interactions in population-based oldest-old people.
The type of study was descriptive. Ethical permission was obtained (13.04.2022/153). All participants were informed, and their written consent was obtained. The "oldest-old" were defined as those who were ≥85 years of age during the study period and living in Turkiye. These people were reached from every region of Turkiye the snowball method and were visited at their homes. Data were collected face-to-face interviews. Age, sex, city of residence, and generic names of regularly used medications were recorded. The medications used were analyzed according to the Beers 2019® Criteria and UpToDate® Lexicomp® drug interaction guides. SPSS was used for statistical analysis, and < 0.05 was considered statistically significant.
Data were collected from the 549 oldest-old people throughout Turkiye. Among the participants, 61.2% ( = 336) were women. The median age of the women was 88.00 years (minimum = 85, maximum = 101), and the median age of the men was 88.00 years (minimum = 85, maximum = 102). The distributions of men and women in the different age groups were similar ( = 0.341). The distributions of men and women across regions were similar ( = 0.826), most of whom ( = 300, 54.6%) had ≥1 potential drug‒drug interaction, according to the UpToDate analysis. The median number of medications used continuously was 4.0 (minimum = 0, maximum = 19). The median number of potential drug‒drug interactions was 1.0 (minimum = 0, maximum = 21). As the number of medications used increased, the number of potential drug‒drug interactions also increased (r = 0.737; = 0.001). The number of potential drug‒drug interactions decreased with increasing age (r = -0.104; = 0.015). According to the Beers 2019® Criteria, potential drug‒drug interactions were detected in only eight patients. The concordance between the Beers 2019® Criteria and the UpToDate®Lexicomb® drug interaction data was poor compared with the number of potential drug‒drug interactions (kappa = 0.024, < 0.001). Central nervous system medications are a common group that can cause potential drug‒drug interactions according to both guidelines. Moreover, potentially inappropriate medications defined by the Beers 2019® Criteria were the most common causes of potential drug‒drug interactions, according to UpToDate®Lexicomb® drug interactions. The frequency of potential drug‒drug interactions was found to be high in the population-based oldest-old people interviewed in Turkiye. It has been determined that the use of more than one guide in the evaluation of potential drug‒drug interactions is safer.
年龄最大的老年人发生潜在药物相互作用的风险最高。因此，本研究的目的是调查以人群为基础的年龄最大的老年人中潜在药物相互作用的频率和类型。
本研究为描述性研究。已获得伦理许可（2022年4月13日/153号）。所有参与者均已被告知并获得其书面同意。“年龄最大的老年人”定义为在研究期间年龄≥85岁且居住在土耳其的人。通过雪球法从土耳其的各个地区找到这些人，并到他们家中进行走访。通过面对面访谈收集数据。记录年龄、性别、居住城市和常用药物的通用名称。根据《2019年Beers标准》和UpToDate® Lexicomp®药物相互作用指南对使用的药物进行分析。使用SPSS进行统计分析，P<0.05被认为具有统计学意义。
从土耳其各地的549名年龄最大的老年人中收集了数据。参与者中，61.2%（n = 336）为女性。女性的年龄中位数为88.00岁（最小 = 85岁，最大 = 101岁），男性的年龄中位数为88.00岁（最小 = 85岁，最大 = 102岁）。不同年龄组中男性和女性的分布相似（P = 0.341）。男性和女性在各地区的分布相似（P = 0.826），根据UpToDate分析，其中大多数人（n = 300，54.6%）存在≥1种潜在药物相互作用。连续使用药物的中位数为4.0种（最小 = 0种，最大 = 19种）。潜在药物相互作用的中位数为1.0种（最小 = 0种，最大 = 21种）。随着使用药物数量的增加，潜在药物相互作用的数量也增加（r = 0.737；P = 0.001）。潜在药物相互作用的数量随着年龄的增加而减少（r = -0.104；P = 0.015）。根据《2019年Beers标准》，仅在8名患者中检测到潜在药物相互作用。与潜在药物相互作用的数量相比，《2019年Beers标准》与UpToDate® Lexicomb®药物相互作用数据之间的一致性较差（kappa = 0.024，P<0.001）。根据这两个指南，中枢神经系统药物是可能导致潜在药物相互作用的常见药物类别。此外，根据UpToDate® Lexicomb®药物相互作用，《2019年Beers标准》定义的潜在不适当药物是潜在药物相互作用的最常见原因。在接受访谈的以人群为基础的土耳其年龄最大的老年人中，发现潜在药物相互作用的频率很高。已确定在评估潜在药物相互作用时使用多个指南更安全。
