Time-Trends of Drug-Drug Interactions among Elderly Outpatients in the Piedmont Region (Italy): A Population-Based Study.
Elisabetta GalaiLorenza ScottiMarco GilardettiAndrealuna UccieroDaniela FerranteElisabetta PoluzziArmando A GenazzaniFrancesco Barone-AdesiPublished in: International journal of environmental research and public health (2022)
Adverse drug reactions (ADRs) are a major health problem in the primary care setting, particularly among the elderly population. While the high frequency of ADRs in the elderly has several causes, a major and common determinant is polypharmacy, which can in turn increase the risk of drug-drug interactions (DDIs). In this paper, we analyzed the drugs prescriptions dispensed to elderly outpatients, to assess changes in the prevalence of selected DDIs in the period 2013-2019. Overall, about 15% of the patients aged >65 years were poly-treated. Among them, a decreasing trend in prevalence was observed for the majority of DDIs during the study period. This trend was particularly noticeable for DDIs involving fluoroquinolones and vitamin K antagonists, where a sharp reduction of over 40% was observed. On the opposite, a small increase in prevalence was observed for the association of antidiabetics and beta-blocking agents and for that of clopidogrel and PPIs. While the occurrence of most of the considered DDIs among poly-treated elderly decreased over time, the prevalence of some of them is still worrying. The complexity of the national drug formularies, as well as the increased number of prescribing actors that are involved, further urges the update of DDI lists to be used to monitor drug appropriateness and reduce avoidable ADRs.
Keyphrases
- adverse drug
- primary care
- middle aged
- high frequency
- community dwelling
- risk factors
- newly diagnosed
- drug induced
- healthcare
- emergency department
- transcranial magnetic stimulation
- electronic health record
- ejection fraction
- end stage renal disease
- acute coronary syndrome
- risk assessment
- mental health
- chronic kidney disease
- coronary artery disease
- sensitive detection
- atrial fibrillation
- percutaneous coronary intervention
- quality improvement
- health information