Clinically relevant drug‐drug interactions and the risk for drug adverse effects among home‐dwelling older persons with and without type 2 diabetes

Abstract

What is known and objective Polypharmacy and age are known to increase the risk for potential drug interactions. Type 2 diabetes has been associated with polypharmacy and several comorbidities. Currently, there is no information on whether the frequency of clinically relevant drug‐drug interactions and the risk for drug adverse effects differ between older persons with and without diabetes. The aim of this study was to investigate the frequency of drug‐drug interactions and the risk for drug adverse effects in these two groups in primary care. Methods The basic study population consisted of Finnish home‐dwelling primary care patients aged ≥ 65 years (N = 3039). For each person with diabetes, two controls were selected with adjusted age and gender. To collect data, electronic primary care patient records, a structured health questionnaire and a structured health examination conducted by a physician were utilized. Using the SFINX‐PHARAO® database, drug‐drug interactions and the risk for drug adverse effects were evaluated in 182 persons with type 2 diabetes and 176 persons without diabetes. Results and discussion There were no significant differences in the frequency of drug‐drug interactions or the risk for drug adverse effects in persons with and without diabetes. At least one clinically relevant interaction was found in 81 (44.5%) persons with diabetes and 73 (41.5%) persons without diabetes. The most common drugs causing interactions included non‐steroidal anti‐inflammatory drugs (NSAIDs) and warfarin. What is new and conclusion There is no difference in the frequency of drug‐drug interactions or risk for drug adverse effects in older home‐dwelling persons with and without diabetes. Due to common comorbidities and commonly used drugs among persons with diabetes, drug‐drug interactions involving warfarin or NSAIDs in particular should be carefully monitored to avoid drug adverse effects.

Polypharmacy, potentially serious clinically relevant drug‐drug interactions, and inappropriate medicines in elderly people with type 2 diabetes and their impact on quality of life

“…30 10.59% of the study cohort were found to have potentially serious clinically relevant DDIs, which is considered higher than previously reported (7.10%). 8 However, a direct comparison is unattainable due to the differences in comorbid conditions and medicines prescribed and different platforms used for assessing DDIs.…”

“…[4][5][6][7] Despite that, there is a paucity in addressing the risk of potential clinically relevant serious DDIs and PIMs. Only one study found that at least one potential serious clinically relevant DDIs was found (7.10%), 8 and two studies found that the prevalence of PIMs was found between (22.70%-68.10%). 9,10 Moreover, there is a lack of evidence on whether the presence of polypharmacy and its consequences can impact quality of life (QoL).…”

Kidney function and nephrotoxic drug use among older home-dwelling persons with or without diabetes in Finland

“…In three studies investigating Australian and American community-dwelling older persons and nursing home residents, 6-28% had been prescribed drugs which were either contraindicated or required dosage adjustments due to their kidney function [19][20][21]. In our previous study, one the most clinically relevant drug-drug interactions concerned NSAID and antihypertensives such as ACE-inhibitors, combination that has also increased risk of nephrotoxicity [30].…”

Estudio piloto: Impacto del farmacéutico en la identificación y evaluación de interacciones potenciales fármaco-fármaco en prescripciones de pacientes hospitalizados de Medicina Interna

“…Estudios como el de Ibáñeza et al, realizado en España, reportaron en pacientes hospitalizados de un servicio de medicina interna, porcentajes de interacciones farmacológicas entre el 0.4 y 39 % en los pacientes medicados (14). Otros estudios han evaluado si esta incidencia podría estar relacionado con padecimientos crónicos como diabetes, no identificando alguna diferencia entre los grupos (44.5 % en pacientes con diabetes vs. 41.5 % en aquellos sin diabetes) al detectar al menos una interacción clínicamente importante (15). En nuestro estudio, el 47.…”