Potential drug-drug interactions in a Brazilian teaching hospital: age-related differences?
Interações medicamentosas potenciais em um hospital escolar brasileiro: diferenças relacionadas à idade?
Rev. ciênc. farm. básica apl; 36 (3), 2015
Publication year: 2015
This study proposes to measure frequency and to
characterize the profile of potential drug interactions
(pDDI) in a general medicine ward of a teaching
hospital. Data about identification and clinical status of
patients were extracted from medical records between
March to August 2006. The occurrence of pDDI was
analyzed using the database monographs Micromedex®
DrugReax® System. From 5,336 prescriptions with
two or more drugs, 3,097 (58.0%) contained pDDI.
The frequency of major and well document pDDI
was 26.5%. Among 647 patients, 432 (66.8%) were
exposed to at least one pDDI and 283 (43.7%) to major
pDDI. The multivariate analysis identified that factors
related to higher rates of major pDDI were the same
age (p< 0.0001), length of stay (p< 0.0001), prevalence
of hypertension [OR=3.42 (p< 0.0001)] and diabetes
mellitus [OR=2.1 (p< 0.0001)], cardiovascular diseases
(p< 0.0001) and the number of prescribed drugs
(Spearman’s correlation=0.640622, p< 0.0001). Between
major pDDI, the main risk was hemorrhage (50.3%),
the most frequent major pDDI involved combination
of anticoagulants and antiplatelet drugs. Among
moderate pDDI, 3,866 (90.8%) involved medicines for
the treatment of chronic non-communicable diseases,
mainly hypertension. In HU-USP, the profile of pDDI
was similar among adults and elderly (the most frequent
pDDI and major pDDI were same), the difference was
only the frequency in either group. The efforts of the
clinical pharmacists should be directed to elderly
patients with cardiovascular compromise, mainly in use
of anticoagulants and antiplatelet drugs. Furthermore,
hospital managers should increase the integration
between levels of health care to promote safety patient
after discharge.
O estudo tem por objetivo descrever o perfil de interações
medicamentosas potenciais (IMP) na clínica médica de
um hospital escola. Dados sobre a identificação e estado
clínico dos pacientes foram extraídos de prontuários
médicos, entre março e agosto de 2006. A ocorrência
de IMP foi analisada empregando-se o banco de
monografias Micromedex DrugReax® System. Das
5.336 prescrições, 3.097 (58,0%) continham IMP. A
frequência de IMP graves e bem documentadas foi
de 26,5%. Entre os 647 pacientes, 432 (66,8%) foram
expostos a pelo menos uma IMP e 283 (43,7%) uma
IMP grave.