Prevalence of cytochrome P450-mediated potential drug-drug interactions in residents of intermediate care facilities for older adults in Japan
Prevalence of cytochrome P450-mediated potential drug-drug interactions in residents of intermediate care facilities for older adults in Japan
复制标题
DOI：
10.1111/ggi.13652
复制
发表时间：
2019-06-01
影响因子：
3.3
通讯作者：
Akishita, Masahiro
中科院分区：
文献类型：
--
作者：
Hamada, Shota;Ohno, Yoshiyuki;Akishita, Masahiro
目的：关于长期护理机构中经常接受多种药物的居民中药物相互作用（DDI）的患病率的信息有限。本研究旨在评价日本老年人中间护理机构（称为Roken）居民中临床相关细胞色素P450介导的潜在DDI的患病率。方法在2015年对Roken居民进行了一项全国范围的药物利用研究（每个设施最多5名居民）。在日本，通过明确列出可能参与临床相关细胞色素P450介导DDI的药物，确定了潜在DDI。使用逻辑回归评估处方药物数量与潜在DDI存在的相关性，并根据年龄、性别和长期护理需求水平进行调整。结果该研究包括348个Roken的1222名居民，他们被处方了两种或更多种活性药物。接受>= 6和>= 10种药物的参与者分别占总参与者的49%和10%。在33例受试者（2.7%）中共确定了42种涉及潜在DDI的两种药物组合-经常涉及苯二氮卓类药物、质子泵抑制剂、钙通道阻滞剂和抗癫痫药物。与接受2 - 5种药物的居民相比，接受6 - 9种药物或≥ 10种药物的居民潜在DDI的调整比值比为2.84（95%置信区间1.15-7.02）或7.82（95%置信区间2.96-20.70）。结论：大约3%的Roken居民有临床相关DDI的风险。通过药物审查减少处方药的数量将减轻潜在的风险。Geriatr Gerontol Int 2019; 19：513-517.
Aim Limited information is available on the prevalence of drug-drug interactions (DDI) in residents of long-term care facilities who often receive multiple drugs. This study aimed to evaluate the prevalence of clinically relevant cytochrome P450-mediated potential DDI in residents of intermediate care facilities for older adults (called Roken) in Japan. Methods A nationwide drug utilization study was carried out for Roken residents in 2015 (up to five residents per facility). Potential DDI were identified with an explicit list of drugs that can be involved in clinically relevant cytochrome P450-mediated DDI in Japan. Logistic regression was used to evaluate the association of the number of drugs prescribed with the presence of potential DDI, adjusted for age, sex and long-term care needs level. Results The study included 1222 residents of 348 Roken who were prescribed two or more active drug substances. The participants who received >= 6 and >= 10 drugs represented 49% and 10% of total participants, respectively. In total, 42 two-drug combinations involving potential DDI were identified in 33 participants (2.7%) - benzodiazepines, proton pump inhibitors, calcium channel blockers and anti-epileptic drugs were frequently involved. The adjusted odds ratios for potential DDI were 2.84 (95% confidence interval 1.15-7.02) or 7.82 (95% confidence interval 2.96-20.70) in residents receiving six to nine drugs or >= 10 drugs, compared with those receiving two to five drugs. Conclusions Approximately 3% of Roken residents were at risk for clinically relevant DDI. Reducing the number of drugs prescribed through medication reviews would mitigate the potential risk. Geriatr Gerontol Int 2019; 19: 513-517.