Occurrence of potential drug-drug interactions in nursing home residents

K N van Dijk, Corinne S de Vries, P B van den Berg, J R B J Brouwers, L T W de Jong-van den Berg

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective — It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents.

Method — The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions. Key findings — Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P<0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline.

Conclusion — During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.

Original languageEnglish
Pages (from-to)45-52
Number of pages8
JournalInternational Journal of Pharmacy Practice
Volume9
Publication statusPublished - 2001

Fingerprint

Drug interactions
Nursing
Nursing Homes
Drug Interactions
Pharmaceutical Preparations
Pharmacokinetics
Drug Combinations
Pharmaceutical Databases
Pharmacodynamics
Theophylline
Anticoagulants
Metabolism

Cite this

van Dijk, K. N., de Vries, C. S., van den Berg, P. B., Brouwers, J. R. B. J., & de Jong-van den Berg, L. T. W. (2001). Occurrence of potential drug-drug interactions in nursing home residents. International Journal of Pharmacy Practice, 9, 45-52.

Occurrence of potential drug-drug interactions in nursing home residents. / van Dijk, K N; de Vries, Corinne S; van den Berg, P B; Brouwers, J R B J; de Jong-van den Berg, L T W.

In: International Journal of Pharmacy Practice, Vol. 9, 2001, p. 45-52.

Research output: Contribution to journalArticle

van Dijk, KN, de Vries, CS, van den Berg, PB, Brouwers, JRBJ & de Jong-van den Berg, LTW 2001, 'Occurrence of potential drug-drug interactions in nursing home residents', International Journal of Pharmacy Practice, vol. 9, pp. 45-52.
van Dijk KN, de Vries CS, van den Berg PB, Brouwers JRBJ, de Jong-van den Berg LTW. Occurrence of potential drug-drug interactions in nursing home residents. International Journal of Pharmacy Practice. 2001;9:45-52.
van Dijk, K N ; de Vries, Corinne S ; van den Berg, P B ; Brouwers, J R B J ; de Jong-van den Berg, L T W. / Occurrence of potential drug-drug interactions in nursing home residents. In: International Journal of Pharmacy Practice. 2001 ; Vol. 9. pp. 45-52.
@article{30301ddc78824a5699a72d8c198c7b02,
title = "Occurrence of potential drug-drug interactions in nursing home residents",
abstract = "Objective — It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents. Method — The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions. Key findings — Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P<0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline. Conclusion — During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.",
author = "{van Dijk}, {K N} and {de Vries}, {Corinne S} and {van den Berg}, {P B} and Brouwers, {J R B J} and {de Jong-van den Berg}, {L T W}",
year = "2001",
language = "English",
volume = "9",
pages = "45--52",
journal = "International Journal of Pharmacy Practice",
issn = "0961-7671",
publisher = "Pharmaceutical Press",

}

TY - JOUR

T1 - Occurrence of potential drug-drug interactions in nursing home residents

AU - van Dijk, K N

AU - de Vries, Corinne S

AU - van den Berg, P B

AU - Brouwers, J R B J

AU - de Jong-van den Berg, L T W

PY - 2001

Y1 - 2001

N2 - Objective — It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents. Method — The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions. Key findings — Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P<0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline. Conclusion — During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.

AB - Objective — It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents. Method — The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions. Key findings — Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P<0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline. Conclusion — During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.

M3 - Article

VL - 9

SP - 45

EP - 52

JO - International Journal of Pharmacy Practice

JF - International Journal of Pharmacy Practice

SN - 0961-7671

ER -