Drug-Drug Interactions Associated with Length of Stay and Cost of Hospitalization

Abstract

Purpose To evaluate the prevalence of drug-drug interactions (DDI) in hospitalized patients and to identify associated risk factors. Methods A retrospective cross-sectional analysis of prescription data and medical records from a public hospital in Brazil was conducted to identify potential DDI. Inappropriate drug combinations were identified and classified with a standard drug interaction source. Primary diagnoses were classified with Charlson Comorbidity Index (CCI). Sex, age, polypharmacy and length of stay, among other variables, were correlated with the frequency of potential DDI. Results The study included 589 patients and 3,585 prescriptions. Thirty-seven percent of the patients were exposed to at least one potential interaction during their stay in the hospital. The most frequent interacting pair was Digoxin+Furosemide (11%). In univariate analysis, several variables were associated with DDI, including sex, age, number of prescribed drugs, length and cost of hospitalization and CCI. Multivariate analysis showed that the adjusted odds of being prescribed a potential DDI among patients in polypharmacy was almost five-fold that of patients taking fewer than five drugs. Further, length of stay, CCI and cost of hospitalization were independently associated with DDI. Conclusion Analysis of prescription data found that a substantial number of potential DDI were identified. Results of this study indicate that DDI is associated with number of prescribed drugs, increased duration of stay in the hospital and cost, which suggests that DDI are a significant clinical and economic problem. Potential harm to patients could be avoided. _______________________________________________________________________________________

Prevalence and Pattern of Potential Drug-Drug Interactions in the Critical Care Units of a Tertiary Hospital in Alexandria, Egypt

“…These findings were in accordance with other studies which showed that both variables were indeed two of the major, if not the most important, risk factors for DDIs [6,14,[27][28][29]. Other risk factors for the occurrence of DDIs identified by other studies included sex [27] and length of hospital stay [4,6]. Although the current findings showed that DDIs were not preventable, awareness of the medical team on the prevalence, risk factors and mechanisms involved in the occurrence of potential DDIs can help in the reduction of the real occurrence of DDIs among hospitalized patients in general and the critically ill patients in specific.…”

“…These findings were comparable with those reportd in several studies [4][5][6]13,14,28,31]. Logistic regression analysis for the possible risk factors of DDIs among patients admitted to the CCUs in the present work showed that the age of patient and the number of prescribed drugs were the only significant factors.…”

“…Logistic regression analysis for the possible risk factors of DDIs among patients admitted to the CCUs in the present work showed that the age of patient and the number of prescribed drugs were the only significant factors. These findings were in accordance with other studies which showed that both variables were indeed two of the major, if not the most important, risk factors for DDIs [6,14,[27][28][29]. Other risk factors for the occurrence of DDIs identified by other studies included sex [27] and length of hospital stay [4,6].…”

Potential Drug-Drug Interactions in Psychiatric Ward of a Tertiary Care Hospital: Prevalence, Levels and Association with Risk Factors

“…Prevalence of potential DDIs (pDDIs) in hospital settings has been estimated in some recent studies to be in the range of 27.8 to 51.4 % [2][3][4]. Old age, taking increased number of medications, long hospital stay, gender and comorbid conditions have been reported as common risk factors for DDIs [5][6][7][8][9][10][11].…”

Prevalence and Clinical Significance of Potential Drug-Drug Interactions at Ayder Referral Hospital, Northern Ethiopia

“…A number of studies conducted at different part of the globe [12][13][14][15][16][17][18][19][20][21][22][23] showed that the prevalence of drug-drug interaction as well as its clinical significance (severity of interaction) varies from place to place depending on the presence of alternative drugs, variation in disease epidemiology and composition and level of health care professionals.…”