Drug-drug interactions and their predictors: Results from Indian elderly inpatients

Pharmacy Practice

  • Mandavi Kashyap1PhD. Post Doctoral Fellow. Research Centre, Montreal University, Montreal, Canada.
  • Sanjay D’Cruz2MD, DM. Associate Professor, Department of General Medicine, Government Medical College & Hospital, Chandigarh, India.
  • Atul Sachdev3MD, DM. Professor, Department of General Medicine, Director Principal, Government Medical College & Hospital, Chandigarh, India.
  • Pramil Tiwari4PhD. Professor & Head, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar, India.

Volume 11 Issue 4 Pages 191-195

Abstract

Background: In view of the multiple co-morbidities, the elderly patients receiving drugs are prone to suffer with drug interactions since they receive a greater number of drugs. Objective: The study was undertaken to determine the prevalence of drug interactions, as well as their predictors. Method: The prescriptions of a total of 1510 inpatients were collected prospectively for 1.5 years from inpatients wards of public tertiary care teaching hospital. All the prescriptions were checked for drug interactions using the Micromedex® Drug-Reax database-2010 and Stockley’s Drug Interactions. Regression analyses sought to determine predictors for the drug interaction. Results: The patients, with the average age of 67.2 ±0.2 years, were prescribed an average of 9.15 ±0.03 medications. It was found that out of 1510 prescriptions of inpatients, 126 (8.3%) prescriptions had one or more than one drug interaction. All the identified interactions were severe in nature. The top most interacting drugs were acetylsalicylic acid and anticoagulant (n=59). The second top most interacting drug combination was clopidogrel and proton pump inhibitors (n=51). The most commonly involved drugs in interactions were C (cardiovascular system) and A (alimentary tract and metabolism). Using multivariate binary logistic regression, multiple drugs (Odds Ratio=4.5; 95% Confidence Interval: - 2.38 -9.47) and multiple diagnoses (Odds Ratio=2.6; 95%CI: -1.40 -5.57) were found to be significant predictors for drug interaction. Conclusion: The results of this study substantiate the occurrence of severe drug interactions among Indian elderly inpatients. In order to provide safer pharmaceutical care, the active involvement of clinical pharmacists is a potential option.

Keywords

  • Drug Interactions
  • Inpatients
  • India
Pharmacy Practice

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