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Frequency and determinants of potential drug‐drug interactions in an elderly population receiving regular home visits by GPs ‐ results of the home medication review in the AGnES‐studies
Author(s) -
Hoffmann Wolfgang,
Berg Neeltje,
Thyrian Jochen René,
Fiss Thomas
Publication year - 2011
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.2224
Subject(s) - medicine , logistic regression , medical prescription , drug , population , pediatrics , pharmacology , environmental health
Purpose There is limited knowledge about prevalence and determinants of potential drug‐drug‐interactions (pDDI) in the ambulatory health care setting. In this manuscript we analysed the prevalence and determinants of pDDI in the AGnES home visit population (GP‐supporting, community‐based, e‐health‐assisted, systemic intervention). Methods 779 Home‐dwelling patients received an IT‐supported home medication review (HMR). The interaction monographs of the ABDA‐database were used to identify pDDI. A binary multivariate logistic regression model was used to analyse determinants for occurrence of moderate and serious pDDI, respectively. Results Patients (mean age f: 79.8 yrs; m: 76.2 yrs) took a mean number of 6.8 active substances (SD = 3.3) regularly. 626 patients (80.4%) with an HMR had at least one pDDI (mean = 4.8; SD = 4.4). In 454 patients (58.3%) we found at least one pDDI with moderate or serious relevance (mean = 2.9; SD = 2.8). The most frequent moderate pDDI was the combination of potassium excretion diuretics (e.g. hydrochlorothiazide) with anti‐inflammatory drugs (e.g. ibuprofen; n = 258 patients). Adjusted for age and gender, multiple binary logistic regression showed significant results for the number of taken active substances (continuous variable; OR = 1.48; 95%‐CI 1.382‐1.585), metabolic diseases (OR = 1.52; 95%‐CI 1.039‐2.223), a diagnose of a muscular‐skeletal disease (OR = 1.741; 95%‐CI 1.204‐2.517), infectious disease (OR = 0.127; 95%‐CI 0.021‐0.783), and gastro‐intestinal disease (OR = 0.538; 95%‐CI 0.322‐0.899). Conclusion Using a comprehensive, computer‐assisted HMR in an ambulatory care setting we have identified a high proportion of pDDI of moderate or serious clinical relevance. These pDDI require an intervention from intensified monitoring to a change in medication. Further investigations should focus on clinical outcome of pDDI. Copyright © 2011 John Wiley & Sons, Ltd.