Abstract
Purpose: To identify clinically significant potential drug-drug interactions in cardiac intensive care units of two tertiary care hospitals in Peshawar, Pakistan, and to compare the various potential drug-drug interactions related parameters between the government and private hospitals included in the study. Method: A prospective study was conducted in the cardiac intensive care units of the two hospitals, viz, Lady Reading Hospital Peshawar (LRH) and Northwest General Hospital and Research Center Peshawar (NWGH &RC), which are government and private hospitals, respectively. Samples of 260 and 250 patients from LRH and NWGH & RC, respectively, were evaluated. Patient medication charts were evaluated for potential drug-drug interactions and clinically significant potential drug-drug interactions using Micromedex DrugReax. The data were statistically analyzed. Results: A high prevalence of potential drug-drug interactions was reported in both hospitals: 92 and 96.9 % in Northwest General Hospital and Research Center, and Lady Reading Hospital, respectively, of which half were clinically significant. A total of 19 interacting drug pairs contributed to the clinically significant potential drug-drug interactions. Independent sample t -test showed a significant difference in the potential drug-drug interactions of both hospitals. Furthermore, a significant relationship was found between the number of potential drug-drug interactions, on the one hand, and the number of prescribed drugs and age, on the other. Conclusion: A high prevalence of potential drug-drug interactions, particularly clinically significant potential drug-drug interactions, calls for proper identification of these interactions and monitoring of patients to minimize adverse outcomes and improve patient therapy. Keywords: Pharmacy service, Drug interactions, Critical/intensive care, Adverse outcomes
Highlights
Cardiovascular diseases are a prime cause of high mortality rates throughout the world
This study reported a high prevalence of potential drug-drug interactions (PDDIs) which corresponds to other studies reporting a similar higher prevalence in cardiology
Our study shows that 3.63 and 4.63 PDDIs were present per patient in NWGH & RC and Lady Reading Hospital Peshawar (LRH) respectively while 2.07 and 2.54 clinically significant PDDIs were present per patient in the hospitals respectively
Summary
Cardiovascular diseases are a prime cause of high mortality rates throughout the world. In 2012, World Health Organization (WHO) estimated that 17.5 million people died worldwide due to cardiovascular diseases. Risk factors include diseases like hypertension, hyperlipidemia, diabetes or other diseases which require multiple drug therapy, while behavioral risk factors include unhealthy diet, tobacco use, lack of physical activity and stress [2,3]. Treatment for these diseases require multiple drug administration which when combined with factors like advanced age, co-morbidities and changes in hepatic and renal functions, increases the risk of potential drug-drug interactions (PDDIs) [4,5,6]. Apart for some rare instances, PDDIs are one of the leading causes of hospitalization [11,12]
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