Prevalence of drug interactions in hospital healthcare

Aim of the review To study the prevalence of drug interactions in hospital healthcare by reviewing literature. Method A review was carried out of studies written in Spanish and English on the prevalence of drug interactions in hospital care published in Pubmed between January 1990 and September 2008. The search strategy combined free text and MeSH terms, using the following keywords: “Drug interaction”, “prevalence” and “hospital”. For each article, we classified independent variables (pathology, age of population, whether patients were hospitalized or not, geographical location, etc.) and dependent variables (number of interactions per 100 patients studied, prevalence of patients with interactions, most common drug interactions, and others). Results The search generated 436 articles. Finally, 47 articles were selected for the study, 3 provided results about drug interactions with real clinical consequences, 42 about potential interactions, and 2 described both. The prevalence of patients with interactions was between 15 and 45 % and the number of interactions per 100 patients was between 37 and 106, depending on the group of studies analyzed. There was a considerable increase in these rates in patients with heart diseases and elderly persons. Conclusion There is a large number of studies on the prevalence of drug interactions in hospitals but they report widely varying results. The prevalence is higher in patients with heart diseases and elderly people.

[1]  V. Calvez,et al.  Optimal use of maraviroc in clinical practice. , 2008, AIDS.

[2]  Robert S Van Hare Potential adverse drug interactions in the emergency room (An issue in the quality of care) , 1990 .

[3]  Lisa Wang,et al.  Potential drug interactions in cancer patients receiving supportive care exclusively. , 2008, Journal of pain and symptom management.

[4]  T. Gaeta,et al.  Potential drug-drug interactions in elderly patients presenting with syncope. , 2002, The Journal of emergency medicine.

[5]  R. Schlienger,et al.  Potential drug–drug interactions in the medication of medical patients at hospital discharge , 2003, European Journal of Clinical Pharmacology.

[6]  R. Raschetti,et al.  Suspected adverse drug events requiring emergency department visits or hospital admissions , 1999, European Journal of Clinical Pharmacology.

[7]  H. Ulmer,et al.  Incidence and risk of potential adverse drug interactions in the emergency room. , 2001, Resuscitation.

[8]  J. P. Aguirregoitia,et al.  Evaluación prospectiva de interacciones entre medicamentos en pacientes ingresados mediante una aplicación informática , 2007 .

[9]  L. Tyler,et al.  Prospective evaluation of adverse drug interactions in the emergency department. , 1992, Annals of emergency medicine.

[10]  K. Wilbur,et al.  Drug‐Related Hospitalizations in a Tertiary Care Internal Medicine Service of a Canadian Hospital: A Prospective Study , 2006, Pharmacotherapy.

[11]  G. Gaddis,et al.  Drug interactions in at-risk emergency department patients. , 2002, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[12]  M. F. Gómez,et al.  Estudio de las interacciones entre fármacos antirretrovirales y tratamiento concomitante , 2003 .

[13]  David W Bates,et al.  Frequency of potential azole drug–drug interactions and consequences of potential fluconazole drug interactions , 2005, Pharmacoepidemiology and drug safety.

[14]  P. Fayers,et al.  Patterns of drug prescription in a geriatric evaluation and management unit as compared with the general medical wards: a randomised study , 2005, European Journal of Clinical Pharmacology.

[15]  H. Scheinin,et al.  A medication database – a tool for detecting drug interactions in hospital , 1997, European Journal of Clinical Pharmacology.

[16]  J. Zuckermann,et al.  Profile of drug interactions in hospitalized children , 2007, Pharmacy practice.

[17]  S. Krähenbühl,et al.  Recognition and management of potential drug–drug interactions in patients on internal medicine wards , 2007, European Journal of Clinical Pharmacology.

[18]  G. Peterson,et al.  Drug‐related admissions to an Australian hospital , 1994, Journal of clinical pharmacy and therapeutics.

[19]  A. Rodríguez-Terol,et al.  Calidad estructural de las bases de datos de interacciones , 2009 .

[20]  K. Yusuff,et al.  Physicians' prescribing of anti-hypertensive combinations in a tertiary care setting in southwestern Nigeria. , 2005, Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques.

[21]  P. Devi,et al.  Adverse drug reactions in medical intensive care unit of a tertiary care hospital , 2009, Pharmacoepidemiology and drug safety.

[22]  E. Hahn,et al.  Risk Factors Associated with Adverse Drug Reactions Following Hospital Admission , 2008, Drug safety.

[23]  B. Glintborg,et al.  Drug-drug interactions among recently hospitalised patients – frequent but mostly clinically insignificant , 2005, European Journal of Clinical Pharmacology.

[24]  B. Stricker,et al.  Hospitalisations and emergency department visits due to drug–drug interactions: a literature review , 2007, Pharmacoepidemiology and drug safety.

[25]  M. Langdorf,et al.  Physician versus computer knowledge of potential drug interactions in the emergency department. , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[26]  E. Wiltink Medication control in hospitals. A practical approach to the problem of drug‐drug interactions. , 1998, Pharmacy World and Science.

[27]  T. Moger,et al.  Identification of drug interactions in hospitals – computerized screening vs. bedside recording , 2008, Journal of clinical pharmacy and therapeutics.

[28]  R. Schlienger,et al.  The Prevalence of Potential Drug-Drug Interactions in Patients with Heart Failure at Hospital Discharge , 2006, Drug safety.

[29]  Lisa Wang,et al.  Potential drug interactions and duplicate prescriptions among cancer patients. , 2007, Journal of the National Cancer Institute.

[30]  D. Taylor,et al.  Potential Interactions between Drugs Taken by Emergency Department Patients of an Australian Hospital , 2006 .

[31]  J. Ragnaud,et al.  Drug–drug interactions with systemic antifungals in clinical practice , 2007, Pharmacoepidemiology and drug safety.

[32]  Kay Brune,et al.  Identification of Adverse Drug Reactions in Geriatric Inpatients Using a Computerised Drug Database , 2003, Drugs & aging.

[33]  S. Speedie,et al.  Detecting Drug Interactions: A Review of the Literature , 1990, DICP : the annals of pharmacotherapy.

[34]  S. Riviére,et al.  Adverse Drug Events Associated with Hospital Admission , 2003, The Annals of pharmacotherapy.

[35]  M. Afilalo,et al.  Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. , 2001, Annals of emergency medicine.

[36]  R. Riechelmann,et al.  Potential for drug interactions in hospitalized cancer patients , 2005, Cancer Chemotherapy and Pharmacology.

[37]  S. Davies,et al.  Potential for drug interactions involving cytochromes P450 2D6 and 3A4 on general adult psychiatric and functional elderly psychiatric wards. , 2004, British journal of clinical pharmacology.

[38]  W. Encinosa,et al.  Inappropriate Drug Combinations Among Privately Insured Patients With HIV Disease , 2005, Medical care.

[39]  U. Lalloo Efavirenz and nevirapine interactions with rifampicin: resolving the dilemmas? , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[40]  T. Lodise,et al.  Prevalence and Risk Factors for Clinically Significant Drug Interactions with Antiretroviral Therapy , 2007, Pharmacotherapy.

[41]  Á. Atallah,et al.  Risk of drug interaction: combination of antidepressants and other drugs. , 2003, Revista de saude publica.

[42]  K. Schmader,et al.  The Quality of Pharmacotherapy in Older Veterans Discharged from the Emergency Department or Urgent Care Clinic , 2007, Journal of the American Geriatrics Society.

[43]  R. P. Poblador,et al.  Revisión de interacciones farmacológicas en un Hospital General , 2002 .

[44]  Steve Mok,et al.  Drug-related problems in hospitalized patients with HIV infection. , 2008, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[45]  K. McDonald,et al.  Specialist care of heart failure improves appropriate pharmacotherapy at the expense of greater polypharmacy and drug‐interactions , 2003, European journal of heart failure.

[46]  Allen Huang,et al.  The challenge of managing drug interactions in elderly people , 2007, The Lancet.

[47]  P. Bryant,et al.  Potential drug interactions in a physical medicine and rehabilitation clinic. , 1990, American journal of physical medicine & rehabilitation.

[48]  V. Vlahović-Palčevski,et al.  Potentially inappropriate prescribing to hospitalised patients , 2008, Pharmacoepidemiology and drug safety.

[49]  T Welte,et al.  Drug-drug interactions in medical patients: effects of in-hospital treatment and relation to multiple drug use. , 2000, International journal of clinical pharmacology and therapeutics.

[50]  J. M. Cruciol-Souza,et al.  Prevalence of potential drug-drug interactions and its associated factors in a Brazilian teaching hospital. , 2006, Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques.