Prevalence of drug interactions in elderly patients with multimorbidity in primary care
- 25 February 2017
- journal article
- review article
- Published by Springer Nature in International Journal of Clinical Pharmacy
- Vol. 39 (2) , 343-353
Abstract
Background Drug interactions (DIs) are a significant cause of medication-related problems. The aging population, high chronic diseases prevalence and polypharmacy are closely associated factors. Aim of the review To study the prevalence, types and associated factors of DIs in multimorbidity patients of over 65 years of age in primary care. Methods Relevant studies on DI prevalence in this population were reviewed in PubMed, Cochrane Library and EMBASE (January 2000–December 2015). Independent variables (duration, target population, age, sex, mean of drugs and diseases, geographical localization, DI databases used and study designs) and dependent variables (prevalence, number of DIs per 100 patients and per patient, number of clinically-relevant DIs per 100 patients, most common DI and associated factors) were classified for each article. Results The search generated 749 articles and 46 duplicates were discarded. After reviewing, 10 articles were included. Seven studies were observational and 3 were quasi-experimental. Seven out of 10 used interaction databases. Only 2 studies described both actual and potential DIs. The prevalence of multimorbidity patients with DI ranged from 25.1 to 100% and the number of DIs per 100 patients was from 30 to 388.3. All the lower values correspond to the study conducted at the nursing home. This could be due to special care offered in these centres, where the medication is more controlled. The most frequent DIs were reported in five articles. However, these results could not be correlated since they were ranked using different methodologies. ACEIs, diuretics and NSAID were the most common therapeutic groups. Finally, 5 studies identified factors associated with the presence of potential DIs. The number of drugs and age were the most significant factors. Conclusions There is little evidence of prevalence of actual and potential DIs in elderly patients with multimorbidity in outpatient settings, showing widely heterogeneous results.Keywords
This publication has 40 references indexed in Scilit:
- Inappropriateness of Medication Prescriptions to Elderly Patients in the Primary Care Setting: A Systematic ReviewPLOS ONE, 2012
- Frequency of laboratory measurement and hyperkalaemia in hospitalised patients using serum potassium concentration increasing drugsEuropean Journal of Clinical Pharmacology, 2011
- Geographic Variation in the Quality of PrescribingNew England Journal of Medicine, 2010
- Managing Medications in Clinically Complex EldersJAMA, 2010
- Frequency and nature of drug–drug interactions in a Dutch university hospitalBritish Journal of Clinical Pharmacology, 2009
- Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico CityBMC Health Services Research, 2007
- Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug‐related problemsBritish Journal of Clinical Pharmacology, 2006
- Potentially Inappropriate Medication Prescribing for Elderly Outpatients in Emilia Romagna, ItalyDrugs & Aging, 2006
- Clinical Practice Guidelines and Quality of Care for Older Patients With Multiple Comorbid DiseasesJAMA, 2005
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987