Potential drug-drug interactions in drug therapy for older adults with chronic coronary syndrome at hospital discharge: A real-world study

Abstract

Introduction: Polypharmacy are commonly observed among older adults with cardiovascular disease. However, multiple medications lead to increased risk of drug-drug interactions (DDIs). Therefore, identification and prevention actions related to harmful DDIs are expected in older adults. The study aimed to describe the prevalence of potential DDIs (pDDIs) in discharge prescriptions among older adults with chronic coronary syndrome (CCS).Methods: A single-center cross-sectional study was performed in a tertiary public hospital in Beijing, China. CCS patients aged 65 years and above who were admitted to cardiology wards over a 3-month period and alive at discharge were included. Electronic medical records and discharge prescriptions were reviewed. pDDIs were evaluated through the Lexi-Interact online.Results: pDDIs were identified in 72.9% of the 402 individuals (n = 293). A total of 864 pDDIs were obtained. 72.1% of patients were found with C DDIs (n = 290) and 20.3% were categorized in D and X DDIs (n = 82). The only X DDI was between cyclosporine and atorvastatin. Under category D, glycemia alterations within antidiabetics and increased chances of bleeding with antithrombotic were the most common. Concomitant use of clopidogrel and calcium channel blockers was a frequent situation within category C, followed by synergic blood pressure lowering agents and increased rosuvastatin concentration induced by clopidogrel.Conclusion: DDIs exposure was common in older CCS. DDIs screening tools should be introduced to alert potential adverse effects. Prescribers need to rigorously review or modulate therapies to prevent DDI-related adverse outcomes. Clinical pharmacists should be more involved in complex drug regimen management.

Potential drug–drug interaction and its determinants among patients with cancer receiving chemotherapy in oncology centres of Northwest Ethiopia: an institutional-based cross-sectional study

“…The prevalence of PDDIs identified by three databases was 72.1%, which was in line with the studies conducted in Spain (71.8%)20 and China (72.9%),27 but higher than other studies conducted in the oncology setting in Iran at 62.88%,39 the Netherlands at 46%2 and the USA 40. Similarly, the prevalence rate of the present study is higher in comparison with studies from other specialties such as psychiatry (68.9%),41 internal medicine (43.7%)42 and paediatrics (45.8%) 43.…”

“…Moderate interaction indicates that interactions have the potential to produce harm and may require treatment, and there is a need for close monitoring. Major interaction indicates that interactions produce serious clinical consequences and can cause permanent damage, and such combination should be avoided 27…”

“…Fair indicates that the interaction is identified in at least two case reports with other supporting data, or it is a theoretical interaction based on knowledge of pharmacological agents. Poor indicates that interaction is identified in two case reports only 27…”

“…Major interaction indicates that interactions produce serious clinical consequences and can cause permanent damage, and such combination should be avoided. 27 …”

Traditional Therapeutics and Potential Epidrugs for CVD: Why Not Both?

“…Though there are defined guidelines and pharmacological therapies for the treatment of CVD, several studies have shown that polypharmacy decreases patient adherence and increases drug interactions, especially in older populations [104][105][106]. There can also be adverse side effects to these medications that have harmful consequences.…”