Potential interactions between complementary/alternative products and conventional medicines in a medicare population
Potential interactions between complementary/alternative products and conventional medicines in a medicare population
复制标题
DOI：
10.1345/aph.1k221
复制
发表时间：
2007-10-01
影响因子：
2.9
通讯作者：
Lind, Bonnie K.
中科院分区：
文献类型：
--
作者：
Elmer, Gary W.;Lafferty, William E.;Lind, Bonnie K.
背景：尽管补充和替代药物(CAM)产品在老年人中的使用率很高，但人们对同时使用CAM和传统药物的程度和潜在的不良反应知之甚少。目的：确定在医疗保险人群中同时使用传统药物、处方和非处方药的CAM产品的流行率，并评估不良反应的风险。方法：对1994、1995、1997和1999年的心血管健康研究访谈数据进行回顾性分析。同时将CAM产品和常规药物联合使用的流行率列在表格中。结果：在5052名参与者中，年龄中位数为75岁，女性占60.2%，非裔美国人占16.6%，白人占83.4%。4个时段使用CAM产品的比例分别为6.3%、6.7%、12.8%和15.1%。同时使用CAM产品和常规药物的比例分别为6.0%、6.2%、11.7%和14.4%。在这些人中，294人(5.8%)服用了被认为有显著不良交互作用风险的组合，在393个不同的访谈中观察到了有风险的组合。大多数(379例)涉及因与阿司匹林、华法林、噻氯匹定或己酮可可碱一起使用银杏、大蒜或人参而有出血的风险。另有786例联合用药的观察结果被认为有一些不良反应的风险，尽管是理论上的或不确定的。结论：在医疗保险人群中，同时使用CAM产品和传统药物是很常见的。研究确定银杏和大蒜补充剂与阿司匹林联合使用的风险应该是当务之急。
BACKGROUND: Despite the high prevalence of complementary and alternative medicine (CAM) product use among the elderly, little is known about the extent of concurrent CAM-conventional medicine use and the potential for adverse reactions.OBJECTIVE: To determine the prevalence of CAM product use concurrent with conventional medications, prescription and nonprescription, in a Medicare population and assess the risk for adverse interactions.METHODS: Retrospective analysis was performed on Cardiovascular Health Study interview data from 1994, 1995, 1997, and 1999. The prevalence of concurrent combinations of CAM products and conventional drugs was tabulated. The adverse interaction risks were categorized as unknown, theoretical, and significant.RESULTS: Of 5052 participants, the median age was 75, 60.2% were female, 16.6% were African American, and 83.4% were white. The percent using CAM products during the 4 time periods was 6.3%, 6.7%, 12.8%, and 15.1%. The percent using both CAM products and conventional drugs was 6.0%, 6.2%, 11.7%, and 14.4%. Of these, 294 (5.8%) individuals took combinations considered to have a significant risk for an adverse interaction, Combinations with risk were observed on 393 separate interviews. Most (379) involved a risk of bleeding due to use of ginkgo, garlic, or ginseng together with aspirin, warfarin, ticlopidine, or pentoxi- fylline. An additional 786 observations of combinations were considered to have some, albeit theoretical or uncertain, risk for an adverse interaction.CONCLUSIONS: Concurrent use of CAM products and conventional medicines in a Medicare population was found to be common. Research to define the risks of combining ginkgo and garlic supplements with aspirin should be of high priority.