The relationship between number of drugs and potential drug-drug interactions in the elderly - A study of over 600 000 elderly patients from the Swedish prescribed drug register
The relationship between number of drugs and potential drug-drug interactions in the elderly - A study of over 600 000 elderly patients from the Swedish prescribed drug register
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DOI：
10.2165/00002018-200730100-00009
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发表时间：
2007-01-01
期刊：
影响因子：
4.2
通讯作者：
Klarin, Inga
中科院分区：
文献类型：
--
作者：
Johnell, Kristina;Klarin, Inga
背景：药物-药物相互作用(DDIS)备受关注，因为它们被认为与药物不良反应和住院有关。此外，许多DDIS被认为是可预测和可避免的，因此它们可能被视为教育和干预的目标。目的：利用新的瑞典处方药登记簿分析老年人中用药数量与潜在DDIS概率之间的关系。方法：我们分析了2005年10月至12月在瑞典处方药登记簿登记的年龄、性别和75岁人群的用药数据，并构建了2005年12月31日任意选择的日期每个人的当前处方清单。此后，我们纳入了那些至少有两种配药以捕捉有接触DDIS风险的老年人口的人(n=630 743)。主要的观察指标是潜在的临床相关DDIS(C型)，可能需要调整剂量，以及潜在的严重DDIS(D型)，应避免。结果：在研究人群中，C型潜在DDIS的患病率为26%，D型潜在DDIS的患病率为5%。在调整了年龄和性别后，配药的数量与C型潜在性DDiS的概率之间有很强的相关性，与D型潜在性DDiS的关联性更强。此外，D型潜在性DDiS的概率随着年龄的增长而降低，女性发生D型潜在性DDiS的概率低于男性。结论：D型潜在性DDiS的处方数量与潜在的DDDiS有很强的相关性，尤其是对于潜在的严重DDIS，这意味着尽量减少老年人开药的重要性。我们的研究发现，在老年人中，潜在严重DDiS的概率随着年龄的增加而下降，老年女性潜在严重DDIS的概率低于老年男性，这一发现需要进一步的研究来验证和调查。
Background: Drug-drug interactions (DDIs) are of great concern, as they are known to be related to adverse drug reactions and hospitalisations. In addition, many DDIs are regarded as predictable and avoidable; therefore, they may be considered as targets for education and interventions.Objective: To analyse the relationship between number of dispensed drugs and the probability of potential DDIs among the elderly by using the new Swedish Prescribed Drug Register.Methods: We analysed data on age, sex and dispensed drugs for people aged >= 75 years who were registered in the Swedish Prescribed Drug Register from October to December 2005, and constructed a list of current prescriptions for every individual on the arbitrarily chosen date of 31 December 2005. Thereafter, we included those who had at least two dispensed drugs to capture the elderly population at risk of being exposed to DDIs (n = 630 743). The main outcome measures were potentially clinically relevant DDIs (type C), which may require dose adjustment, and potentially serious DDIs (type D), which should be avoided.Results: The prevalence of type C potential DDIs was 26% and of type D potential DDIs 5% in the study population. There was a strong association between number of dispensed drugs and the probability of type C potential DDIs and an even stronger association for type D potential DDIs, after adjustment for age and sex. In addition, the probability of type D potential DDIs decreased with increasing age, and women had a lower probability of type D potential DDIs than men.Conclusion: There seems to be a strong relationship between number of dispensed drugs and potential DDIs, especially for potentially serious DDIs, which has implications for the importance of trying to minimise the number of drugs prescribed in the elderly. Our findings that the probability of potentially serious DDIs decreases with increasing age among the elderly and that elderly women have a lower probability of potentially serious DDIs than elderly men need to be verified and investigated by further research.