Drug interactions detected by a computer-assisted prescription system in primary care patients in Spain: MULTIPAP study

Rogero-Blanco, Eloísa ; Del-Cura-González, Isabel ; Aza-Pascual-Salcedo, Mercedes ; García de Blas González, Francisca ; Terrón-Rodas, Carmen ; Chimeno-Sánchez, Sergio ; García-Domingo, Eva ; López-Rodríguez, Juan A. ; Gimeno Feliu, Luis (Universidad de Zaragoza) ; on behalf MULTIPAP group

Resumen: Background
Drug interactions increase the risk of treatment failure, intoxication, hospital admissions, consultations and mortality. Computer-assisted prescription systems can help to detect interactions.
Objectives
To describe the drug–drug interaction (DDI) and drug–disease interaction (DdI) prevalence identified by a computer-assisted prescription system in patients with multimorbidity and polypharmacy. Factors associated with clinically relevant interactions were analysed.
Methods
Observational, descriptive, cross-sectional study in primary health care centres was undertaken in Spain. The sample included 593 patients aged 65–74 years with multimorbidity and polypharmacy participating in the MULTIPAP Study, recruited from November 2016 to January 2017. Drug interactions were identified by a computer-assisted prescription system. Descriptive, bivariate, and multivariate analyses with logistic regression models and robust estimators were performed.
Results
Half (50.1% (95% CI 46.1–54.1)) of the patients had at least one relevant DDI and 23.9% (95% CI 18.9–25.6) presented with a DdI. Non-opioid–central nervous system depressant drug combinations and benzodiazepine–opioid drug combinations were the two most common clinically relevant interactions (10.8% and 5.9%, respectively). Factors associated with DDI were the use of more than 10 drugs (OR 11.86; 95% CI 6.92–20.33) and having anxiety/depressive disorder (OR 1.98; 95% CI 1.31–2.98). Protective factors against DDI were hypertension (OR 0.62; 95% CI 0.41–0.94), diabetes (OR 0.57; 95% CI 0.40–0.82), and ischaemic heart disease (OR 0.43; 95% CI 0.25–0.74).
Conclusion
Drug interactions are prevalent in patients aged 65–74 years with multimorbidity and polypharmacy. The clinically relevant DDI frequency is low. The number of prescriptions taken is the most relevant factor associated with presenting a clinically relevant DDI.

Idioma: Inglés

DOI: 10.1080/13814788.2021.1917543

Año: 2021

Publicado en: EUROPEAN JOURNAL OF GENERAL PRACTICE 27, 1 (2021), 90-96
ISSN: 1381-4788

Factor impacto JCR: 3.636 (2021)

Categ. JCR: PRIMARY HEALTH CARE rank: 4 / 18 = 0.222 (2021) - Q1 - T1
Categ. JCR: MEDICINE, GENERAL & INTERNAL rank: 66 / 172 = 0.384 (2021) - Q2 - T2

Factor impacto CITESCORE: 8.5 - Medicine (Q1)

Factor impacto SCIMAGO: 1.689 - Medicine (miscellaneous) (Q1) - Family Practice (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII-FEDER/RD16-0001-0004
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI18-01303
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI18-01515
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI18-01812
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD16-0001-0005
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD16-0001-0006

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)