Potential drug interactions in drug therapy prescribed for older adults at hospital discharge: cross-sectional study.
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Universidade Federal de Minas Gerais
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BACKGROUND: Older adults with a range of comorbidities are often prescribed multiple medications,
which favors drug interactions.
OBJECTIVES: To establish the frequency of potential drug interactions in prescriptions at hospital discharge
among older adults and to identify the associated factors.
DESIGN AND SETTING: Cross-sectional study conducted in a public hospital.
METHODS: An initial face-to-face interview, data collection from the electronic medical records (covering
sociodemographic, clinical, functional and drug therapy-related variables) and telephone follow-up after
discharge were conducted to confirm the medication prescribed at discharge. Drug interactions were identified
through the Micromedex DrugReax software, along with interactions that should be avoided among
the elderly, as per the 2015 American Geriatric Society/Beers criteria. Multivariable logistic regression was
performed.
RESULTS: Potential for drug interactions was identified in the discharge drug therapy of 67.8% of the 255 older
adults evaluated (n = 172), and 54.5% (n = 145) of the drug interactions were major. Among the drug interactions
that should be avoided among older adults, those that increase the risk of falls were the most frequent.
The drug interactions thus identified were independently associated with polypharmacy (odds ratio,
OR = 12.62; 95% confidence interval, CI 6.25-25.50; P = 0.00), diabetes mellitus (OR = 2.16; 95% CI 1.05-4.44;
P = 0.04), hypothyroidism (OR = 7.29; 95% CI 2.03-26.10; P = 0.00), chronic kidney disease (OR = 3.41; 95% CI
1.09-10.64; P = 0.03) and hospitalization in geriatric units (OR = 0.45; 95% CI 0.22-0.89; P = 0.02).
CONCLUSION: The frequency of potential drug interactions in drug therapy prescribed at discharge for
these older adults was high. Polypharmacy, diabetes mellitus, hypothyroidism and chronic kidney disease
were positively associated with occurrences of drug interactions, while hospitalization in geriatric units
showed an inverse association.
Abstract
Assunto
Interações medicamentosas, Idoso fragilizado, Alta do paciente, Terapia medicamentosa
Palavras-chave
Drug interactions, Frail elderly, Patient discharge, Drug therapy
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https://www.scielo.br/j/spmj/a/LThYwWW8TnK8JTC8sBV3c4w#