Potential drug interactions in drug therapy prescribed for older adults at hospital discharge: cross-sectional study

Abstract

The number of older adults in the world is expanding rapidly as a consequence of increased quality of life and technological advances. 1,2 This demographic transition is increasing the prevalence of chronic-degenerative diseases. One of the consequences is higher consumption of medicines, which implies a great challenge for the healthcare system. 3 Given that use of several drugs is needed to treat the multimorbidity commonly seen in older adults, it can be expected that the prevalence of polypharmacy among older adults and the risk of drug interactions will increase substantially. 4 Drug interactions are a common cause of adverse drug reactions among older adults, and these include arrhythmias, acute kidney injury and increased risk of falls. 5-7 A direct correlation between the number of medications and their interactions and the risk of adverse drug reactions has been shown. 4-7 The reasons for this are multifactorial and particularly include age-related changes in the pharmacodynamics and pharmacokinetics of drugs, reduced renal function and lower hepatic clearance. 6-8 At hospital discharge, older adults generally present changes to their drug therapy, with higher numbers of prescribed medications, which leads to higher frequency of drug interactions. 8 Thus, it is essential to know the frequency of these interactions at hospital discharge among older people and their determinants, in order to promote safer use of drugs among older adults.

Drug safety profiles in geriatric patients with Parkinson’s disease using the FORTA (Fit fOR The Aged) classification: results from a mono-centric retrospective analysis

“…The number of administered drugs correlates directly with the number of DDIs (Dias et al 2019). The proportion of patients with at least one moderate (72.6% versus 26% in or severe interaction (34.7% versus 5% in in our PD cohort was higher than in other cohorts (Johnell and Klarin 2007;Sánchez-Arenas et al 2012).…”

Study on medication prescription in the elderly population: benzodiazepine use and potential drug interactions

“…Given the high frequency of drug interactions and polypharmacy, there is an evident need for an approach that ensures safe drug therapy for older adults 7 . Strategies may consider possible therapeutic alternatives and patient monitoring.…”

“…Strategies may consider possible therapeutic alternatives and patient monitoring. Interventions conducted by pharmacists within this practical setting, such as drug therapy reviews and actions planned with the prescriber, may reduce the number of older patients with clinically relevant drug interactions 7 .…”

“…Due to the number of prescribed drugs, the complexity of treatment regimens, especially in the presence of comorbidities, and the pharmacokinetic and pharmacodynamic changes inherent in the aging process, older people are more vulnerable to adverse drug reactions, include DI 7 .…”

Interações Medicamentosas Potenciais E Polifarmácia Em Prescrições De Pacientes Acompanhados Por Farmacêuticos Clínicos Em Unidades De Terapia Intensiva

“…Com relação à presença de comorbidades, as mais frequentes foram HAS e DM. No presente estudo, a frequência dessas condições de saúde foi inferior à encontrada por Dias et al 20 , na avaliação de IMP, na alta hospitalar em idosos, com 71% de paciente hipertensos e 43,1% com diabetes, o uso associado de vários fármacos para tratar essas doenças, podem justificar a presença dessas IMP.…”