Polypharmacy, Aging and Potential Drug-Drug Interactions in Outpatients in Taiwan

Lin, Chien-Chen; Wang, Chun Yu; Bai, Chyi Huey

doi:10.2165/11586870-000000000-00000

Cited by 71 publications

(72 citation statements)

References 29 publications

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“…Caffeine + Phenylephrine 2 A retrospective study by Lin et al 11 in outpatients in Taiwan emphasis that polypharmacy increases the risk of DDIs. In present study, maximum number of patients prescribed two drugs per prescription.…”

Section: Decrease Sedative Effectmentioning

confidence: 99%

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Mistry¹,

Gor²,

Ganguly³

2017

JYP

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Objective: To evaluate prevalence, types and severity of drug-drug interactions in paediatric outpatient department. Methods: An observational study was carried out in Shree Krishna Hospital (SKH), a tertiary care teaching hospital after obtaining Institutional Ethics Committee approval. In SKH outpatient prescriptions are uploaded on software "Solace" , and these online prescriptions were collected from IT department. Potential Drug-drug interactions (pDDIs) were identified by using Medscape drug interaction checker. The prescriptions were analysed for demographic characteristics, medical and detailed drug history. Drug-drug interactions (DDIs) were evaluated for total numbers, types and severity of DDIs. Result: Total 300 prescriptions with mean age 6.33 ± 5.24 years were analysed. Total 96 pDDIs were recorded. The prevalence of pDDI was 16%. Most common pDDI was Valproic acid + Acetaminophen. There were 61 (63.54%) DDIs of pharmacokinetic, 24 (25%) pharmacodynamic and 11 (11.46%) had an unknown mechanism. Out of all interactions, 41 (42.71%) were of minor, 48 (50%) were of moderate and 07 (7.29%) were of severe in nature. The number of drugs prescribed and the occurrence of DDIs were significantly associated. (p<0.001). This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Section: Decrease Sedative Effectmentioning

confidence: 99%

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Mistry¹,

Gor²,

Ganguly³

2017

JYP

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“…For each patient, the number drugs prescribed and ATC code classification of drug therapy were analyzed as drug therapy characteristics. Selected predictor factors were chosen in accordance with the results of previous studies [22,25,28,31].…”

Section: Predictors Of Potential Ddismentioning

confidence: 99%

“…Additionally, the frequency study of potential DDIs at geriatric outpatient in 6 European countries showed that there were differences in frequency, as well as in the type of potential DDIs [23]. By study of predictors to DDIs was also observed variability, those which are patient characteristics as well as those which are therapy characteristics [20][21][22][24][25][26][27][28][29][30][31][32]. Differences in healthcare settings, registered and reimbursed pharmaceutical specialities can contribute to different utilization patterns of prescription drugs.…”

mentioning

confidence: 99%

Prevalence and predictors of potential drug-drug interactions

Nikolic¹,

Janković

Stojanov³

et al. 2014

Open Medicine

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“…7 Polypharmacy, defined as the concomitant use of multiple medications (e.g., customarily five or more medications), has been associated with increasing age 8,9 and with an increased risk of adverse drug reactions, increased hospitalizations, poor adherence, inappropriate drugs, falls and fractures, and drug-drug interactions. [10][11][12][13][14][15] The risk for drug-drug interactions may be particularly increased among the aging population of HIV-infected adults due to treatments for multiple comorbidities in this population [16][17][18][19] as well as the concomitant use of ARV therapy. Among the antiretroviral classes, non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) are major substrates as well as both inhibitors and inducers of the cytochrome P450 (CYP) enzyme system.…”

Section: Introductionmentioning

confidence: 99%

“…Although polypharmacy and its impact on drug-drug interactions has been well-described in various studies from the general population, 13,14,[25][26][27][28][29][30][31][32][33] there are limited data among the aging population of HIV-infected adults. 2,[34][35][36] Therefore, we sought to examine the potential impact of polypharmacy on the risk of drug-drug interactions between ARVs and other medications (ARV/non-ARV interactions) in a US cohort of HIV-infected adults seen in the outpatient setting.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and Risk of Antiretroviral Drug Interactions Among the Aging HIV-Infected Population

et al. 2013

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BACKGROUND: Among aging HIV-infected adults, polypharmacy and its consequences have not been welldescribed. OBJECTIVE: To characterize the extent of polypharmacy and the risk of antiretroviral (ARV) drug interactions among persons of different ages. DESIGN AND PARTICIPANTS: Cross-sectional analysis among patients within the HIV Outpatient Study (HOPS) cohort who were prescribed ARVs during 2006-2010. MAIN MEASURES: We used the University of Liverpool HIV drug interactions database to identify ARV/non-ARV interactions with potential for clinical significance. KEY RESULTS: Of 3,810 patients analyzed (median age 46 years, 34 % ≥ 50 years old) at midpoint of observation, 1,494 (39 %) patients were prescribed ≥ 5 non-ARV medications: 706 (54 %) of 1,312 patients ≥ 50 years old compared with 788 (32 %) of 2,498 patients < 50 years. During the five-year period, the number of patients who were prescribed at least one ARV/non-ARV combination that was contraindicated or had moderate or high evidence of interaction was 267 (7 %) and 1,267 (33 %), respectively. Variables independently associated with having been prescribed a contraindicated ARV/non-ARV combination included older age (adjusted odds ratio [aOR] per 10 years of age 1.17, 95 % CI 1.01-1.35), anxiety (aOR 1.78, 95 % CI 1.32-2.40), dyslipidemia (aOR 1.96, 95 % CI 1.28-2.99), higher daily non-ARV medication burden (aOR 1.13, 95 % CI 1.10-1.17), and having been prescribed a protease inhibitor (aOR 2.10, 95 % CI 1.59-2.76). Compared with patients < 50 years, older patients were more likely to have been prescribed an ARV/non-ARV combination that was contraindicated (unadjusted OR 1.44, 95 % CI 1.14-1.82), or had moderate or high evidence of interaction (unadjusted OR 1.29, 95 % CI 1.15-1.44). CONCLUSIONS: A substantial percentage of patients were prescribed at least one ARV/non-ARV combination that was contraindicated or had potential for a clinically significant interaction. As HIV-infected patients age and experience multiple comorbidities, systematic reviews of current medications by providers may reduce risk of such exposures.

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Polypharmacy, Aging and Potential Drug-Drug Interactions in Outpatients in Taiwan

Cited by 71 publications

References 29 publications

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Prevalence and predictors of potential drug-drug interactions

Polypharmacy and Risk of Antiretroviral Drug Interactions Among the Aging HIV-Infected Population

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