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Abstract
BackgroundPotential drug–drug interactions (pDDIs) are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure. In developing countries like Pakistan, this issue remains poorly addressed. The objective of this study was to explore prevalence of pDDIs in the Outpatient Department (OPD) of a tertiary care hospital in Pakistan. The secondary aim was to describe the levels of reported pDDIs and develop a list of widespread clinically relevant interactions.MethodsPrescriptions of 2400 OPD patients were analyzed for pDDIs through Micromedex Drug-Reax®. Prevalence, severity- and documentation-levels and widespread clinically relevant interactions were reported.ResultsOf total 2400 prescriptions, pDDIs were present in 22.3%. Whereas, moderate- and major-pDDIs were found in 377 (15.7%) and 225 (9.4%), respectively. PDDIs were more prevalent in Medicine (9.2%) and Cardiology (2.6%) as compared with other OPD specialties. Total 942 pDDIs were identified, of which, the majority were either moderate- (61.9%) or major-pDDIs (32.1%). Some of the most common interactions were ibuprofen + levofloxacin (n = 50), ciprofloxacin + diclofenac (32), aspirin + atenolol (24), and diclofenac + levofloxacin (19). The potential adverse outcomes of widespread interactions were seizures, bleeding, QT-interval prolongation, arrhythmias, tendon rupture, hypoglycemia/hyperglycemia, serotonin syndrome, drug toxicity, and decreased therapeutic response.ConclusionsOPD patients were at risk to pDDIs, particularly to major- and moderate-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
Potential drug–drug interactions are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure [1]
adverse drug reactions (ADRs) are responsible for nearly 5% of hospital admissions, of which, 0.25 to 25% are due to drug-drug interactions (DDIs) [1, 3,4,5,6]
At a time Potential drug–drug interactions (pDDIs) of different severity levels were present in many prescriptions
Summary
Potential drug–drug interactions (pDDIs) are one of the preventable drug related problems having the risk of serious adverse events or therapeutic failure [1]. Their associated adverse drug reactions (ADRs) may lead to morbidity or mortality [2]. Some studies from the developed countries have reported a prevalence rate of 28–83% for pDDIs in OPD [4, 14, 16,17,18,19] These studies are limited by the nature of study settings, design, DDIs screening tool, and drug prescribing pattern
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