Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region

被引：18

作者：

Burato, Sofia ^{[1
]}

Leonardi, Luca ^{[2
]}

Antonazzo, Ippazio Cosimo ^{[1
]}

Raschi, Emanuel ^{[1
]}

Ajolfi, Chiara ^{[3
]}

Baraghini, Manuela ^{[4
,5
]}

Chiarello, Antonella ^{[6
]}

Delmonte, Valentina ^{[7
]}

Di Castri, Lucio ^{[8
]}

Donati, Monia ^{[9
]}

Fadda, Antonella ^{[6
]}

Fedele, Daniela ^{[10
]}

Ferretti, Alessandra ^{[11
]}

Gabrielli, Laura ^{[11
]}

Gobbi, Silvia ^{[4
,5
]}

Lughi, Sereno ^{[4
,5
]}

Mazzari, Martina ^{[8
]}

Pieraccini, Fabio ^{[4
,5
]}

Renzetti, Alessandro ^{[3
]}

Russi, Elsa ^{[7
]}

Scanelli, Chiara ^{[12
]}

Zanetti, Barbara ^{[9
]}

Poluzzi, Elisabetta ^{[1
,13
]}

机构：

[1] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[2] Univ Pisa, Post Grad Sch, Dept Pharm, Hosp Pharm, Pisa, Italy

[3] Local Hlth Author Modena, Modena, Italy

[4] Local Hlth Author Romagna, Forli Unit, Emilia Romagna, Italy

[5] Local Hlth Author Romagna, Cesena Unit, Emilia Romagna, Italy

[6] Local Hlth Author Imola, Imola, Italy

[7] Local Hlth Author Parma, Parma, Italy

[8] Local Hlth Author Piacenza, Piacenza, Italy

[9] Local Hlth Author Bologna, Bologna, Italy

[10] Local Hlth Author Ferrara, Ferrara, Italy

[11] Local Hlth Author Reggio Emilia, Reggio Emilia, Italy

[12] Univ Hosp Ferrara, Ferrara, Italy

[13] Univ Bologna, Ctr Studies & Res Elderly, Bologna, Italy

来源：

FRONTIERS IN PHARMACOLOGY | 2021年 / 11卷

关键词：

drug-drug interactions (DDIs); older peolpe; drug utilization; inappropriateness; nursing home; community dwelling; RISK; OUTPATIENTS; MEDICATION; SAFETY;

D O I：

10.3389/fphar.2020.624888

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Backround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies. Methods: We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 years-old were collected from nine Local Health Authorities of Emilia Romagna: data on community-dwelling subjects were extracted from archives of reimbursed prescriptions, while drug use in a sample of nursing homes was recorded from clinical charts in one index day within the same semester. The frequency of polypharmacy (at least five or at least 10 concurrent drugs) and of each DDI was calculated. Results: In line with different rates of polypharmacy (80% vs 16%), the risk of exposure to at least one interaction was 53.7% in nursing homes and 26.4% in outpatients. Among DDIs, in nursing homes antidepressants-anxiolytics (11.9%) ranked first, followed by antidepressants-aspirin (7.4%). In outpatients, ACE-inhibitors-non-steroidal anti-inflammatory drugs (NSAIDs) reached 7.2% followed by the calcium channel blockers-alpha-blockers (2.4%). Discussion: Polypharmacy and risk of DDIs appeared very different in the two settings, due to both technical and clinical reasons. In order to reduce use of benzodiazepines, NSAIDs, antidepressants and relevant DDIs, 1) defining alternative options for pain relief in elderly outpatients, and 2) implementing non-pharmacological management of insomnia and anxiety in nursing homes should be prioritized.

引用

页数：7

共 31 条

[1] Prevalence of drug herb and drug-supplement interactions in older adults: a cross-sectional survey [J].