Potential drug-drug interactions in older adults: A population-based study

被引:22
作者
Araujo Santos, Thalyta Renata [1 ]
Silveira, Erika Aparecida [2 ]
Pereira, Lilian Varanda [3 ]
Provin, Mercia Pandolfo [1 ]
Lima, Dione Marcal [1 ]
Amaral, Rita Goreti [1 ]
机构
[1] Univ Fed Goias, Sch Pharm, 1a Ave,Esquina Com Praca Univ S-N, BR-74605220 Goiania, Go, Brazil
[2] Univ Fed Goias, Med Sch, Postgrad Program Hlth Sci, Goiania, Go, Brazil
[3] Univ Fed Goias, Nursing Sch, Goiania, Go, Brazil
关键词
elderly; polypharmacy; potential drug-drug interactions; narrow therapeutic index; recommended clinical management; POLYPHARMACY;
D O I
10.1111/ggi.13070
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
AimTo evaluate the potential drug-drug interactions (PDDI) between drugs used by older adults, any associated factors and recommended clinical management. MethodsA cross-sectional, population-based study was carried out through a home survey of 934 older adults (from December 2009 to April 2010). A questionnaire was applied, and the participants were asked to show all the drugs used and their respective prescriptions, thus providing data to identify polypharmacy, self-medication and PDDI. PDDI, their consequences, severity and clinical management were identified using Micromedex. ResultsOverall, 2846 drugs and 665 PDDI were identified, 71.0% of which were moderate and 22.4% serious. The prevalence of PDDI was 36.9%. Drugs with a narrow therapeutic index were involved in 17.0% of the PDDI. The variables female sex (PR=1.11, 95% CI 1.02-1.20), age 80years (PR=1.15, 95% CI 1.03-1.28), no polypharmacy (PR=0.72, 95% CI 0.67-0.78) and no hospitalization in the past year (PR=0.90, 95% CI 0.82-0.97) remained associated with the presence of three or more PDDI in the final multivariate analysis model. ConclusionsMost PDDI were related to routinely used drugs (enalapril, hydrochlorothiazide, calcium, captopril, levothyroxine and simvastatin), and more than one-third of the older adults were exposed to PDDI with the possible risk of serious health consequences. Drugs with a narrow therapeutic index were involved in several PDDI, with increased risk of toxicity. The clinical management procedures most recommended are dose adjustment and dosing changes, control of the drugs' serum levels, and monitoring of the clinical conditions. Geriatr Gerontol Int 2017; 17: 2336-2346.
引用
收藏
页码:2336 / 2346
页数:11
相关论文
共 27 条
  • [1] 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension
    Afridi, I
    Canny, J
    Yao, CH
    Christensen, B
    Cooper, RS
    Kadiri, S
    Hill, S
    Kaplan, N
    Kuschnir, E
    Lexchin, J
    Mendis, S
    Poulter, N
    Psaty, BM
    Rahn, KH
    Sheps, SG
    Whitworth, J
    Yach, D
    Bengoa, R
    Ramsay, L
    Kaplan, N
    Mendis, S
    Poulter, N
    Whitworth, J
    [J]. JOURNAL OF HYPERTENSION, 2003, 21 (11) : 1983 - 1992
  • [2] Medicine use by the elderly in Goiania, Midwestern Brazil
    Araujo Santos, Thalyta Renata
    Lima, Dione Marcal
    Kyosen Nakatani, Adelia Yaeko
    Pereira, Lilian Varanda
    Leal, Geraldo Sadoyama
    Amaral, Rita Goreti
    [J]. REVISTA DE SAUDE PUBLICA, 2013, 47 (01): : 94 - 103
  • [3] Understanding and preventing drug interactions in elderly patients
    Delafuente, JC
    [J]. CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2003, 48 (02) : 133 - 143
  • [4] Gotardelo D.R., 2014, REV BRASILEIRA MED F, V9, P111
  • [5] GRAHAMESMITH DG, 2002, OXFORD TXB CLIN PHAR, P105
  • [6] Gravina CF, 2010, ARQ BRAS CARDIOL, V95, P16
  • [7] GuimarAes PM, 2010, ARQ CIENC SAUDE, V17, P192
  • [8] Hanlon Joseph T, 2005, Am J Geriatr Pharmacother, V3, P61, DOI 10.1016/S1543-5946(05)00030-9
  • [9] Quality of pharmacotherapy and outcomes for older veterans discharged from the emergency department
    Hastings, S. Nicole
    Schmader, Kenneth E.
    Sloane, Richard J.
    Weinberger, Morris
    Pieper, Carl F.
    Goldberg, Kenneth C.
    Oddone, Eugene Z.
    [J]. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2008, 56 (05) : 875 - 880
  • [10] Potentially Harmful Drug-Drug Interactions in the Elderly: A Review
    Hines, Lisa E.
    Murphy, John E.
    [J]. AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY, 2011, 9 (06) : 364 - 377