Prevalence Of Drug Interactions Research Articles

Potential Drug-Drug Interactions in Outpatient Lung Cancer Patients in a University Hospital.

Concomitant use of drugs in the same or different indications can sometimes lead to undesirable interactions. The prevalence of drug interactions is high in cancer patients. In this study, we aimed to determine the frequency and clinical severity of drug interactions in outpatient lung cancer patients. The drugs used, kidney and liver blood analysis results of 160 outpatient lung cancer patients over the age of 18 years who received chemotherapy between October 2020 and July 2021 were evaluated. The Lexi-Interact online database was used to identify the types of clinically significant drug interactions, frequently interacting drugs, and clinical outcomes predicted by the databases. The average number of drugs per patient was 4.2 ± 2.3. It was determined that there was a relationship between multidrug use and comorbidity, and the number of drugs used increased as the number of diagnoses increased. A relationship was also found between potential drug-drug interactions (pDDIs), which we observed in 52.5% of the patients, and the number of drugs used and age. The most common clinically significant C- (36.9%), D- (16.9%), and X- (10.6%) type pDDIs were detected between conventional paclitaxel-hydrochlorothiazide, conventional paclitaxel-carboplatin, and ipratropium-tiotropium, respectively. The use of frequently interacting drugs in outpatient lung cancer patients can lead to pDDIs. In these patients, the application of therapy by observing the drug-drug interaction may improve the quality of life.

Evaluation of Prescription Errors in Teaching Hospital

INTRODUCTION Prescription errors have been frequent problem in health care settings. Due to prescription error patients lose their faith towards healthcare providers. Therefore the study of prescription errors is necessary to promote rational use of medicine. The aim of the study was to assess the prescription errors found in the different wards of our institution. MATERIAL AND METHODS A prospective observational study was conducted from June 2022 to January 2023 in a tertiary care teaching hospital in Kathmandu. Prescriptions of 350 patients admitted to the different wards of the hospital were included in the study after obtain ing ethical clearance from institutional review committee. A convenience sampling technique was used for collection of the data and the primary data were collected from the patient cardex and recorded in pre-designed proforma consisting of information about, diagnosis of disease and findings related to prescription errors. Data were entered in the MS excel and further analysis was done using IBM Statistical Package for Social Sciences (SPSS) version 21. RESULTS A total of 350 prescriptions belonging to patients admitted to the different wards were analyzed. Prescription errors were detect- ed in 86 prescriptions. Errors of omission were found in 19 prescriptions and 67 prescriptions showed error of commission. Among errors of commission drug interactions were most common. CONCLUSION Nearly one fourth of prescriptions analyzed showed prescription error. Among them most common were errors of commission. Prevalence of drug interactions is significant and needs to be monitored more promptly in our institution.

Potential Drug Interactions in Adults Living in Manaus: A Real-World Comparison of Two Databases, 2019.

Drug information systems are commonly used by professionals to assist in the identification of drug interactions and to ensure the safe use of medications. Real-world evidence about the comparison of different drug interaction sources is scarce. We aimed to compare two drug interaction databases to identify interactions in a population-based survey. This is a cross-sectional study based on a previous survey performed in the city of Manaus, Brazil, in 2019. We included adults aged 18 years and over, who used two or more medicines 15 days before the interview. To assess potential drug interactions, we searched Micromedex and UpToDate databases. The primary outcome was the prevalence of potential drug interactions in each database. Weighted Kappa statistics were calculated to assess agreement on the presence of drug interaction, documentation and severity. A total of 752 participants were included in the study. The prevalence of drug interactions was 43.8% [95% confidence interval (CI): 40.2, 47.3%] in UpToDate and 30.2% (95% CI: 26.9, 33.5%), in Micromedex. The agreement related to drug interactions between the two databases was fair (Kappa: 0.631). For severity (Kappa: 0.398) and documentation (Kappa: 0.311), the agreement was poor. Agreement among compared databases was sub-optimal. Better quality and transparency of evidence available in drug interaction sources are needed to support informed healthcare professionals' decision.

Implantação do cuidado farmacêutico em uma Clínica-Escola de Fisioterapia

Chronic diseases usually refer to comorbidities and the continuous use of drugs to improve health, leaving the individual susceptible to polypharmacy and problems in pharmacotherapy. This article aims to describe the clinical performance of pharmacists and interns in a Physiotherapy School Clinic, during the period from March 2019 to March 2020, offering clinical services of pharmacotherapeutic follow-up, screening and health education. This is a prospective, descriptive and quantitative study of individuals over 50 years of age, who used polypharmacy and who had problems and/or doubts regarding pharmacotherapy. The collection of data referring to the patients was recorded using a form prepared by the authors and the methodology used in the follow-ups was the Dadér Method. Socio-demographic profile, associated morbidities/comorbidities, medications and drug related problems (DRPs) were analyzed. Thirty-nine patients participated in the study in health screening services (n=9), pharmacotherapeutic follow-up (n=30) and health education (n=39). Service users were elderly, predominantly male (56.7%), hypertensive and diabetic, with consumption of 325 medications (average of 10.83 medications/patient), 35.4% of which were from the cardiovascular system, with 87 DRPs and 75.9% prevalence of drug interactions. During the study there was great support from the physiotherapists of the School Clinic in referring patients to pharmaceutical services. The predominance of polypharmacy and DRPs presented by the patients evidenced the need for a pharmaceutical professional in the study environment, for the integral restoration of health and improvement of pharmacotherapy, ensuring the rational use of medicines

Prevalence of drug interactions in hospitalised elderly patients: a systematic review

Background: The prevalence of drug–drug interactions (DDIs) in hospital settings is variable, and elderly patients are considered a high risk population for DDIs. There are no systematic reviews describing the prevalence of DDIs in hospitalised elderly patients. Objectives: To assess and summarise the available data on the prevalence of DDIs in hospitalised elderly patients and to describe which drugs, drug classes and drug combinations are most commonly involved in DDIs. Data source: A systematic electronic literature search was conducted on Medline/PubMed, Embase, Lilacs, SciElo, Web of Science, Cinahl, Scopus, Cochrane, OpenGrey, Capes Thesis Bank, OasisBR, OpenAire and abstracts from scientific events, without limitation on language or period of publication. Study selection was completed on 21 September 2018. Study eligibility criteria, participants and interventions: Original observational studies that reported the prevalence of actual or potential DDIs during hospitalisation in patients aged 60 years or older were included. The main outcome measure was prevalence of DDIs and number of DDIs per patient. Subgroup analysis was performed in studies that reported the prevalence of DDIs in geriatric units. Study appraisal and synthesis methods: Study quality was assessed using the Agency for Healthcare Research and Quality methodological checklist for cross sectional and prevalence studies. Results: 34 studies were included, involving 9577 patients. The prevalence of DDIs ranged from 8.34% to 100%. In studies conducted in geriatric units, the prevalence ranged from 80.5% to 90.5%. The number of DDIs per patient ranged from 1.2 to 30.6. Single drugs most commonly involved in DDIs were furosemide, captopril, warfarin and dipyrone. Drug classes mostly involved were potassium sparing diuretics and angiotensin converting enzyme inhibitors. Limitations: The main limitation is the heterogeneity between the included studies that precluded a metaanalysis. Several different methods were used to identify DDIs, majorly, and potential DDIs. Few studies have reported measures to control the quality of the collected data. Conclusions and implications of key findings: The prevalence of DDIs ranged widely, and the variation may reflect differences in the conditions of the elderly patients and level of attention (or complexity of care), as well as methodological differences, especially the methods and/ or software used to identify DDIs.

453Use of Non-vitamin K antagonist Oral Anticoagulants in a real-world setting: a community pharmacy-based study

Abstract Background The emergence of non-vitamin K antagonist oral anticoagulants (NOAC) has caused a paradigm shift in anticoagulation therapy, with NOAC being increasingly used compared to vitamin K antagonists. Despite the numerous RCTs with NOAC, further follow-up on how this high risk new drug class is used in real-world clinical practice is warranted. Purpose This study aimed to describe NOAC use in a primary care sample of long-term NOAC users, and investigated (i) adherence, (ii) patients' perceptions, (iii) drug interactions and (iv) appropriateness of dosing. Methods A cross-sectional observational study was conducted in 158 community pharmacies. Participants were home-dwelling adults treated with a NOAC for at least one year. They completed a questionnaire collecting data on socio-demographics, clinical characteristics, current medication use, self-reported adherence to NOAC (via Medication Adherence Report Scale, MARS), and beliefs and perceptions about NOAC (via Beliefs about Medicines Questionnaire, BMQ). Adherence to NOAC (self-reported (MARS) and calculated using pharmacy dispensing data (Medication Possession Ratio (MPR)); patients' beliefs and perceptions about NOAC (BMQ); and prevalence of drug interactions and inappropriate dosing (using the recommendations in the summary of product characteristics (SmPC) and the 2018 European Heart Rhythm Association (EHRA) Practical Guide) were assessed. Results Participants (n=766) had a mean age of 76.2±8.8 years, several co-morbidities (median of 5 (IQR 4–6)) and high thromboembolic risk (median CHA2DS2-VASc score of 4 (IQR 3–4)). The majority (93.5%) used NOAC for non-valvular atrial fibrillation, while the other 6.5% used it for the prevention of recurrent deep vein thrombosis or pulmonary embolism. Forty point five percent of the study sample used rivaroxaban, 36.2% apixaban, 21.1% dabigatran and 2.2% edoxaban. About 85% was adherent according to MPR (MPR ≥80%) and self-reported adherence was also high (mean MARS score 24.6±1.0). Two-thirds reported at least one adverse event of the NOAC, with easy bruising/bleeding being most prevalent (40.2% of patients). BMQ showed that 91.3% of patients favoured the “necessity” over the “concerns” of NOAC use. Thirty-one percent of patients had ≥1 drug interaction(s) with NOAC; amiodarone (10.4% of patients), antiplatelet agents (9.7%) and NSAIDs (9.0%) were the most common interacting drugs. NOAC dosing was inappropriate in 15.9% of patients according to SmPC and in 23.1% according to EHRA. Intriguingly, underdosing was more common using the SmPC as reference, while overdosing was more common using the EHRA guideline. Conclusions This real-world analysis of NOAC use revealed high adherence and necessity beliefs, drug interactions in 30% of patients, and suboptimal dosing in about one fifth of patients. These findings can inform the design of targeted community pharmacist interventions to improve quality of NOAC use.

Drug interactions among older adults followed up in a comprehensive medication management service at Primary Care.

ABSTRACTObjective:To estimate the prevalence of drug interactions and associated factors among older adults followed up in a Comprehensive Medication Management Service at Primary Care.Methods:Firstly, the Beers criteria 2015 was used to define drug interactions; later, drug interactions proposed by Dumbreck for patients with diabetes, depression, and heart failure were evaluated. The associated factors were assessed by univariate (Pearson's χ2) and multivariate analyses (logistic regression). The significance level of 5% was set for all analyses.Results:The mean age of the studied population was 70.2±7.8 years; 52.2% were between 60 and 69 years, and 61.3% were female. Among the older adults, 94.5% used two or more drugs (condition for the occurrence of drug-drug interaction). The prevalence of drug interaction according to the Beers criteria was 4.9%. After multivariate analysis, diseases of the central nervous system, arrhythmia, number of medications, and female sex were positively associated with drug interaction. The prevalence of drug interaction according to Dumbreck was 27.2%. After multivariate analysis, the number of medications, the presence of heart failure, and Charlson comorbidity index greater than 1 were conditions positively associated with drug interactions.Conclusion:The holistic and individualized approach used in comprehensive medication management services for older patients is important, considering the prevalence of drug interactions and the need to minimize adverse events.

Prevalence of drug interactions in elderly patients with multimorbidity in primary care.

Background Drug interactions (DIs) are a significant cause of medication-related problems. The aging population, high chronic diseases prevalence and polypharmacy are closely associated factors. Aim of the review To study the prevalence, types and associated factors of DIs in multimorbidity patients of over 65years of age in primary care. Methods Relevant studies on DI prevalence in this population were reviewed in PubMed, Cochrane Library and EMBASE (January 2000-December 2015). Independent variables (duration, target population, age, sex, mean of drugs and diseases, geographical localization, DI databases used and study designs) and dependent variables (prevalence, number of DIs per 100 patients and per patient, number of clinically-relevant DIs per 100 patients, most common DI and associated factors) were classified for each article. Results The search generated 749 articles and 46 duplicates were discarded. After reviewing, 10 articles were included. Seven studies were observational and 3 were quasi-experimental. Seven out of 10 used interaction databases. Only 2 studies described both actual and potential DIs. The prevalence of multimorbidity patients with DI ranged from 25.1 to 100% and the number of DIs per 100 patients was from 30 to 388.3. All the lower values correspond to the study conducted at the nursing home. This could be due to special care offered in these centres, where the medication is more controlled. The most frequent DIs were reported in five articles. However, these results could not be correlated since they were ranked using different methodologies. ACEIs, diuretics and NSAID were the most common therapeutic groups. Finally, 5 studies identified factors associated with the presence of potential DIs. The number of drugs and age were the most significant factors. Conclusions There is little evidence of prevalence of actual and potential DIs in elderly patients with multimorbidity in outpatient settings, showing widely heterogeneous results.

A Prospective Study on Prevalence of Drug Interactions in Prescriptions at a Teritarycarehospital

Aim : To study the prevalence of drug interactions in prescriptions at a tertiary care teaching hospital. To assess and preventability of drug interactions. To analyze preventable events to develop prevention strategies. Methodology : Patients prescribed with at least one drug interaction containing prescription were monitored. In the pre-implementation study period, out of the 100 patients, 57-prescriptions were with drug interactions and 43 prescriptions were without drug interactions. The total number of drug combinations found to be interactive was 120 in which the severity of drug interactions were evaluated using micromedex database and the interacting drugs were classified based on the WHO First level ATC Code. Results : The major category of drugs causing drug interactions were found to be antibiotics 57% , cardiac drugs 45%, NSAID'S 33%, and antipsychotic drugs 23% the post-implementation study period, 25 prescriptions were screened. Out of which, only 9 prescriptions had interactions. Discussion : Five interventions were made, and there was a marked decrease in the number of drug interactions with appropriate interventions by the pharmacist. The present study by clinical pharmacist proved that drug interaction study among antibiotic class of drug is effective in identifying and reducing potentially serious adverse drug interactions among antibiotics and other drugs administered to patients. Conclusion : Thus the potential for interaction between antibiotics and other drugs needs to be borne in mind, especially with theincreasing trend towards polypharmacy.

The Study of Harmful and Beneficial Drug Interactions in Intensive Care, Kerman, Iran

Since multidrug therapy is common in the intensive care unit (ICU), the risk of drug interactions is high. This study aimed to examine the prevalence of drug interactions and risk factors in patients who were admitted to ICUs. In a cross-sectional study, the medication flow sheet of 101 patients was investigated in terms of the number and the type of drug interactions. The Drug Interaction Facts reference text book (2010 edition) was used to determine the type and the number of drug interactions. In total, 609 potential drug interactions were found. The mean number of drug interactions per patient was 6.1 (SD=5.6). Of all observed drug interactions, 66.9% were classified as harmful and 33.1% beneficial. In terms of the nature of interactions, delayed, moderate, and possible were the most common types. The most frequent harmful interaction was between phenytoin and omeprazole (63 occasions). Critically ill patients are at a higher risk of drug interactions. Although 33.1% of the drug interactions were considered beneficial, medical teams should be aware that even beneficial interactions can have undesirable side-effects in the critically ill.

Prevalence of drug interactions in hospital healthcare

To study the prevalence of drug interactions in hospital healthcare by reviewing literature. A review was carried out of studies written in Spanish and English on the prevalence of drug interactions in hospital care published in Pubmed between January 1990 and September 2008. The search strategy combined free text and MeSH terms, using the following keywords: "Drug interaction", "prevalence" and "hospital". For each article, we classified independent variables (pathology, age of population, whether patients were hospitalized or not, geographical location, etc.) and dependent variables (number of interactions per 100 patients studied, prevalence of patients with interactions, most common drug interactions, and others). The search generated 436 articles. Finally, 47 articles were selected for the study, 3 provided results about drug interactions with real clinical consequences, 42 about potential interactions, and 2 described both. The prevalence of patients with interactions was between 15 and 45 % and the number of interactions per 100 patients was between 37 and 106, depending on the group of studies analyzed. There was a considerable increase in these rates in patients with heart diseases and elderly persons. There is a large number of studies on the prevalence of drug interactions in hospitals but they report widely varying results. The prevalence is higher in patients with heart diseases and elderly people.

O122 Prevalence of drug interactions between antiretroviral and co-administered drugs at the Moi teaching and referral hospital (Ampath), Eldoret, Kenya

O122 Prevalence of drug interactions between antiretroviral and co-administered drugs at the Moi teaching and referral hospital (Ampath), Eldoret, Kenya

Herbal, Prescribed, and Over-the-Counter Drug Use in Older Women: Prevalence of Drug Interactions

Older adults are at particular risk for drug and herbal interactions because they have multiple health problems that require treatment and are generally more susceptible to adverse drug effects. This study used a database containing self-reported herbal, prescription, and over-the-counter (OTC) drugs concurrently taken by a sample of 58 women who were aged 65 years or older. Drug-drug interactions (DDIs) were identified using a Web-based pharmaceutical program. At least 1 moderate or high-risk DDI was identified in 74% of participants, with 136 total DDIs identified. Fifty-two percent (71) of total DDIs were between prescribed and OTC or herbals, with 63% (45) of these involving nonsteroidal antiinflammatory drugs (NSAIDs). It is imperative that health care providers identify all prescribed, OTC, and herbal drugs taken by their patients and assess all interactions in order to avoid the possibility of adverse drug effects.

The effect of active training in reducing severe drug interactions

Background: Purpose: Methods: Results Conclusion RUG INTERACTIONS , ACTIVE TRAINING : Drug interactions are common medical errors in Gorgan province and training can decrease their rate. Keywords. D : Overall prevalence of drug interactions was 8.93%, of which 6.55% were major, 65.58% moderate and 27.87% minor. Interactions were mostly seen among male doctors. The physicians with an average drug number of more than 4 had significantly more interactions in their prescriptions. The majority of physicians with major drug interactions did not know their clinical significance. After training, there was a significant reduction in major drug interactions, but none in moderate and minor interactions for which no education was provided. With an initial estimation of 8% severe drug interactions (95% confidence level, 7% accuracy), the sample size was calculated to include at least 5600 prescriptions. After classifying the observed interactions and identifying the physicians, a questionnaire was prepared and completed attending their offices. Training was provided using face-to-face conversation, audit feedback and educational notes. After training on the severe interactions, physicians’ prescriptions were reviewed again after three months and the number of interactions was compared with that observed at baseline, to evaluate the effect of training. Data were classified, computerized and analyzed with SPSS-10 using Chi-square and McNemar tests. The interactions’ clinical importance was also evaluated using relative test. To evaluate the effect of educational interventions including face-to-face, audit feedback and educational notes, among Gorgan physicians. Journal of Medical Education Fall 2004 6(1);107-112 Medication errors are among the most important medical errors. Considering the current trend of poly-pharmacy and a high average number of drugs in prescriptions, drug interactions are of great significance.