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Abstract
Objective: The aim of the present study was to assess the prevalence, risk rating and the severity of hazardous pDDIs (potential drug-drug interactions) in the prescribed pharmacotherapy in the hospital discharged heart failure (HF) patients, primarily with co-administered drugs with narrow therapeutic index (statins, anticoagulants, antithrombotic drugs).
 Methods: The prescriptions of chronic heart failure patients for one year (January-December 2014) were analyzed for pDDIs through Lexi-interact® software. DDIs belonging to the categories D (Consider therapy modification) and X (Avoid combination) and/or severity of drug interaction-major, were selected for the study.
 Results: After reviewing the medical records of 985 patients, 239 patients were selected based on the criteria mentioned above. The average number of prescription drugs at hospital discharge was 7.27 medications (±1.84 SD) per patient. The total number of pDDIs was 1483 or approximately 6.2 (±3.89 SD) pDDIs per patient. With respect to the risk rating, in categories D and X were detected 76 (5.12 %) and 2 (0.13 %) pDDI, respectively. The major pDDIs were 108 (7.28 %).
 Conclusion: HF patients are at high risk of pDDIs. Screening of prescriptions for pDDIs and monitoring of pharmacotherapy in terms of response and associated adverse drug events will contribute to patient safety.
Highlights
Heart failure (HF) affects more than 20 million people worldwide, with a 6-10% prevalence of people over 65 y of age [1]
All of the patients were with hypertension, the other accompanying diseases included atrial fibrillation (41 %), diabetes mellitus (41 %), and anemia (40.6 %)
A total of 199 out of the 239 selected patients (83.3 %) in the study were elderly, and 98 % of them received more than 5 drugs and gave us the reason to assign these patients as high-risk patients in terms of hazardous pDDIs and their therapy needed higher alertness [3, 6, 12]
Summary
Heart failure (HF) affects more than 20 million people worldwide, with a 6-10% prevalence of people over 65 y of age [1]. The therapeutic regimens for the treatment of HF are very complex, including many pharmacological groups, and leading to polypharmacy, with great potential of drug-drug interactions (DDIs) [3,4,5]. There is no consensus on the definition of "polypharmacy", but in order to facilitate and reduce the degree of confusion, we will apply the most commonly used definition in the scientific literature, namely, the use of five or more drugs simultaneously [6]. "Polypharmacy" often leads to an increased risk of drug-related adverse reactions [7]. The older population is most affected by polypharmacy and its consequences. Increasing the prevalence of age-related chronic illnesses is accompanied by increased drug intake, as in the case with patients with HF
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