Dataset Information

Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan.

ABSTRACT:

Background

Aging population, is a reality in many countries because of improvement in the health care, patient safety and other supplemental factors. Pharmacotherapy in this population must be evaluated due to their higher susceptibility to adverse drug outcomes, like potential drug-drug interactions (PDDIs). Research in this regard is limited particularly in developing countries. The aim of the study was to evaluate the prevalence and associated factors in this population.

Methods

The multicentered study evaluated the prevalence of potential drug-drug interactions and associated factors in elderly population at critical care units in Peshawar, Pakistan. Potential drug-drug interactions were evaluated using Micromedex DrugReax, while statistical analysis was performed using SPSS.

Results

A total of 70.17% elderly patients were observed to have at least one PDDI. A significant association was observed between presence of PDDIs and number of prescribed drugs, duration of stay and age (p < 0.05). A total of 3019 PDDIs were observed, attributing to 225 drug pairs. Prevalent PDDIs were of moderate severity, good documentation and pharmacodynamic in nature. One-way ANOVA revealed a significant difference in the means of PDDIs between Northwest general hospital and the rest of the hospitals. Moreover, there was a significant difference in the means of PDDIs of CCU and SU with rest of the units.

Conclusion

The prevalence of PDDIs was observed to be high in elderly population which can be managed by avoiding or managing a limited number of drug combinations. Such studies are necessary to evaluate the risks of these PDDIs in a population which is already physiologically compromised.

SUBMITTER: Shakeel F

PROVIDER: S-EPMC6288845 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan.

Shakeel Faisal F Aamir Muhammad M Khan Ahmad Farooq AF Khan Tayyiba Nader TN Khan Samiullah S

BMC pharmacology & toxicology 20181210 1

<h4>Background</h4>Aging population, is a reality in many countries because of improvement in the health care, patient safety and other supplemental factors. Pharmacotherapy in this population must be evaluated due to their higher susceptibility to adverse drug outcomes, like potential drug-drug interactions (PDDIs). Research in this regard is limited particularly in developing countries. The aim of the study was to evaluate the prevalence and associated factors in this population.<h4>Methods</h ...[more]

PMID: 30526670

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Project description:The elderly are considered as special population, as they differ from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics, vulnerability to drug-drug interactions and adverse drug reactions. Despite the fact that the elderly patients are at high risk of having drug interaction and potential adverse outcomes, studies in this regard are scarce in resource limited settings like Ethiopia. The aim of this study was to assess the prevalence and determinants of potential drug-drug interaction in elderly patients admitted to medical ward of Ayder Referral Hospital in Northern Ethiopia.A cross sectional study was conducted among elderly inpatients aged 60 years and above. The study was conducted from February to May 2014. Prescribed drugs being taken concurrently for at least 24 h were included and checked for drug-drug interaction using Micromedex® 2.0 online drug reference. Data were analyzed using statistical software, statistical package for social sciences for windows version 20. Logistic regression model was used to analyze factors associated with occurrence of drug interaction. P value of <0.05 was considered statistically significant.A total of 140 patients were participated in the study. The mean age (±standard deviation) of participants was 68 (±7) years. Majority (61.4 %) of patients were diagnosed with cardiovascular and/or renal diseases. A total of 814 drugs were prescribed with a mean of 6 (±4) medications per patient during a 13 (±9) days of hospital stay. About two-third (62.2 %) of the respondents were exposed to at least one potential drug-drug interaction. Among these 3.6, 32.9 and 25.7 % of patients had taken contraindicated drug combination, at least one major and at least one moderate drug-drug interaction, respectively. Patients with five or more prescribed medications were four times at risk of having drug-drug interaction (P = 0.00; adjusted odds ratio 4.047; 95 % confidence interval 1.867-8.775).Drug-drug interaction in elderly patients was common in this resource limited set-up. Awareness creation and clinical pharmacist involvement in minimizing the risk associated with potentially harmful drug combinations are needed.

Project description:Reports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan.A descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value < .05 indicated statistical significance.In 600 hospitalized in-patient (male 52.7% and female 47.3%) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80% (A02: drugs for acid related disorders 64.5%, A03: drugs for functional gastrointestinal disorders 21.5%), N: nervous system 66.3% (N02: analgesics 67.2%, N03: antiepileptic's 11.2%), J: anti-infectives for systemic use 62.2% (J01: antibacterial for systemic use 82.5%, J04: antimycobacterials 15.3%) and C: cardiovascular system 48.3% (C07: beta blocking agents 19.8%, C10: lipid modifying agents 16.5%), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3%), N02BE01 (paracetamol 50.8%) and J01DD04 (ceftriaxone 40.2%), respectively. In multiple linear regression analysis, male gender (95% CI -.205, -.006, p = .039, B = -.091), being divorced (95% CI -.604, -.136, p = .002, B = -.130) and presence of comorbidity (95% CI .068, .267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy.The rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.

Dataset Information

Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan.

Background

Methods

Results

Conclusion

Publications

Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan.

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