Potential herb-drug interactions in community-dwelling older adults in China: the Shanghai Aging Study
Potential herb-drug interactions in community-dwelling older adults in China: the Shanghai Aging Study
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DOI：
10.1007/s40520-020-01489-0
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发表时间：
2020-02-01
影响因子：
4
通讯作者：
Wang, Bin
中科院分区：
文献类型：
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作者：
Chi, Danyi;Ding, Ding;Wang, Bin
背景潜在的草药-药物相互作用(PHDI)通常不被认识，而且对PHDI在老年人中的流行情况知之甚少。目的本研究旨在调查上海市社区老年人暗娼感染的流行情况，并找出与暗娼感染相关的模式和影响因素。方法应用Lexi-InterAct在线软件对上海市老年人口老龄化研究的基线数据进行分析，该研究旨在建立上海老年人的社区前瞻性队列。结果在1227名使用任何药物-草药或草药组合的参与者中，43.3%的人至少接触过一种PHDI。在研究样本中共鉴定出1641种不同的PHDI。只有7例(0.4%)PHDI被评为风险类别X，这表明这些组合是禁忌的，应该避免。令人担忧的是，876例(53.4%)pHDI被评为D类风险，这表明可能会发生显著的相互作用，应该考虑进行治疗改进。特别令人担忧的是，99.8%的D类抗凝血药物涉及具有抗凝/抗血小板特性的草药。中风(优势比[OR]2.02)、高脂血症(OR 1.51)或心脏病(OR 1.42)、草药数量(2.66)、药物数量(OR 1.21)和年龄(OR 1.02)与PHDI的风险显著相关。结论社区老年人中有43.3%接触过中草药或中草药的任意组合，其中一半以上与具有抗凝血/抗血小板作用的中草药有关。了解这些PHDI的模式和高危人群可能有助于提高患者的安全性。
Background Potential herb-drug interactions (pHDIs) often go unrecognized, and little is known about the prevalence of pHDIs in older adults. Aims This study aimed to investigate the prevalence of pHDIs in community-dwelling older adults in Shanghai and identify patterns and factors associated with pHDIs. Methods Baseline data from the Shanghai Aging Study, which was designed to establish a prospective community-based cohort of older adults in Shanghai, were analyzed regarding pHDIs with Lexi-Interact Online software. Results Among 1227 participants who used any combination of drug-herb or herb-herb, 43.3% were exposed to at least one pHDI. A total of 1641 different pHDIs were identified among the study samples. Only seven (0.4%) pHDIs were rated as risk category X, indicating that the combinations were contraindicated and should be avoided. Worryingly, 876 (53.4%) pHDIs were rated as risk category D, indicating that significant interactions may occur and therapeutic modification should be considered. Of particular concern is that 99.8% of pHDIs in risk category D involve herbs with anticoagulant/antiplatelet properties. Individuals with stroke (odds ratio [OR] 2.02), hyperlipidemia (OR 1.51) or heart diseases (OR 1.42) and the number of herbs (2.66), number of drugs (OR 1.21), and age (OR 1.02) were significantly associated with the risk of pHDIs. Conclusion 43.3% of community-dwelling older adults who used any combination of drug-herb or herb-herb was exposed to pHDIs, and more than half of pHDIs were related to herbs with anticoagulant/antiplatelet properties. Awareness of the patterns and high-risk groups of these pHDIs may contribute to increased patient safety.