Prevalence of the Prescription of Potentially Interacting Drugs
Prevalence of the Prescription of Potentially Interacting Drugs
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DOI：
10.1371/journal.pone.0078827
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发表时间：
2013-10-11
期刊：
影响因子：
3.7
通讯作者：
Catapano, Alberico Luigi
中科院分区：
文献类型：
--
作者：
Tragni, Elena;Casula, Manuela;Catapano, Alberico Luigi
多种药物的使用越来越普遍，相应地增加了不良反应的风险以及与药物相关的发病率和死亡率。我们的目的是估计相关的潜在相互作用的药物处方的流行率，并在评估潜在的相互作用的药物暴露的可能的预测因素。我们回顾性地分析了2004年1月至2005年8月间意大利两个地区近210万人的处方数据。我们通过检查临床相关性、文献和意大利的使用量，确定了27对潜在相互作用的药物。选择至少接受一次两种药物处方的受试者。合并处方是指“同一天开两张处方”，合并用药是指“开两种重叠的药物”。进行逻辑回归分析，以检查潜在药物相互作用（pDDI）的预测因素。957，553例受试者（占研究人群的45.3%）暴露于27对药物/类别中的至少一种。总体而言，pDDI发生了2，465，819次。ACE抑制剂+NSAID的合并处方和联合处方率最高（6，253和4，621/100，000计划参与者）。考虑到伴随疾病，男性/女性比例= 70岁。平均而言，参与pDDI的受试者接受>= 10种药物。年龄>= 65岁、男性和服用大量药物的人的暴露几率更高。观察到大量具有临床意义的pDDI，尤其是在华法林使用者中。了解最流行的pDDI可以帮助从业者预防合并使用，从而提高药物处方的质量，并可能避免不必要的副作用。
The use of multiple medications is becoming more common, with a correspondingly increased risk of untoward effects and drug-related morbidity and mortality. We aimed at estimating the prevalence of prescription of relevant potentially interacting drugs and at evaluating possible predictors of potentially interacting drug exposure. We retrospectively analyzed data on prescriptions dispensed from January 2004 to August 2005 to individuals of two Italian regions with a population of almost 2.1 million individuals. We identified 27 pairs of potentially interacting drugs by examining clinical relevance, documentation, and volume of use in Italy. Subjects who received at least one prescription of both drugs were selected. Co-prescribing denotes "two prescriptions in the same day", and concomitant medication "the prescription of two drugs with overlapping coverage". A logistic regression analysis was conducted to examine the predictors of potential Drug-Drug Interaction (pDDIs). 957,553 subjects (45.3% of study population) were exposed to at least one of the drugs/classes of the 27 pairs. Overall, pDDIs occurred 2,465,819 times. The highest rates of concomitant prescription and of co-prescription were for ACE inhibitors+NSAIDs (6,253 and 4,621/100,000 plan participants). Considering concomitance, the male/female ratio was = 70 years. On average, subjects involved in pDDIs received >= 10 drugs. The odds of exposure were more frequently higher for age >= 65 years, males, and those taking a large number of drugs. A substantial number of clinically important pDDIs were observed, particularly among warfarin users. Awareness of the most prevalent pDDIs could help practitioners in preventing concomitant use, resulting in a better quality of drug prescription and potentially avoiding unwanted side effects.