Clinical Data Combined With Modeling and Simulation Indicate Unchanged Drug‐Drug Interaction Magnitudes in the Elderly

2020 ◽  
Author(s):  
Felix Stader ◽  
Perrine Courlet ◽  
Hannah Kinvig ◽  
Melissa A. Penny ◽  
Laurent A. Decosterd ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Modeling And Simulation ◽  
Clinical Data ◽  
The Elderly ◽  
Unchanged Drug ◽  
Drug Drug Interaction

The burden and management of cytochrome P450 2D6 (CYP2D6)-mediated drug-drug interaction (DDI): co-medication of metoprolol and paroxetine or fluoxetine in the elderly

2017 ◽  
Vol 26 (7) ◽  
pp. 752-765 ◽  
Author(s):  
Muh. Akbar Bahar ◽  
Eelko Hak ◽  
Jens H.J. Bos ◽  
Sander D. Borgsteede ◽  
Bob Wilffert
Keyword(s):  
Cytochrome P450 ◽  
Drug Interaction ◽  
The Elderly ◽  
Cytochrome P450 2D6 ◽  
Drug Drug Interaction ◽  
P450 2D6

scholarly journals Reduction of drug-drug interaction and inappropriate prescription in polymedicated elderly who consult in the ambulatory

2021 ◽  
Vol 6 (4) ◽  
pp. 86-88
Author(s):  
Fajreldines A
Keyword(s):  
Drug Interaction ◽  
Adverse Events ◽  
Drug Interactions ◽  
The Elderly ◽  
Total Sample ◽  
Outpatient Setting ◽  
Inappropriate Drug ◽  
Inappropriate Prescription ◽  
Post Intervention ◽  
Drug Drug Interaction

Introduction: Older adults or elderly people over 64 years of age are patients more vulnerable to suffering adverse events related to medication, and this can generate states of both physical and psychological discomfort, loss of autonomy, mental disorders, etc. Objectives: To analyze the drug-drug interaction and inappropriate prescription of drugs in the outpatient setting in the elderly and implement barriers to reduce this problem. Materials and methods: Quasi-experimental study, of the before after type. The Beers 2019 criteria were used to assess inappropriate drug prescribing. The Uptodate definition of drug-drug interactions and their classification were used. Results: 203 polypathological, sarcopenic elderly patients were studied. These patients attended the outpatient consultation during the 2016-2018 period. 99 patients participated in the pre-intervention and 104 in the post-intervention. The distribution by sex was: 110 (54.2%) women and 93 (45.8%) men. The mean age was 77.3 + 13.3 years. In the total sample analyzed before the intervention, 33 (33.3%) showed inappropriate prescription of drugs criteria. Drug interactions in the pre-intervention were present in 51 patients (51.5%). After the intervention that consisted of training doctors with the Beers criteria and editing a list with clinically relevant interactions in the elderly, which can cause adverse events, inappropriate prescription was reduced to 26 patients (25%), p = 0.05, and clinically relevant interactions were reduced from 51 (51.51%) to 12 (11.53%), p = 0.003. The association between inappropriate prescription and clinically relevant interactions is OR: 3.23 (95% CI 1.91-3.88). Conclusions: The proportion of patients with inappropriate prescription is within the ranges published by various authors as well as drug interactions, the intervention was good to reduce the two problems in this sample of patients.

scholarly journals Targeting continuity of care and polypharmacy to reduce drug–drug interaction

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yi-An Weng ◽  
Chung-Yeh Deng ◽  
Christy Pu
Keyword(s):  
Drug Interaction ◽  
Relative Risk ◽  
Continuity Of Care ◽  
The Elderly ◽  
Mediation Effect ◽  
Excess Relative Risk ◽  
Policy Interventions ◽  
Taiwan National Health Insurance ◽  
Drug Drug Interaction ◽  
Positive Effect

AbstractDrug–drug interaction (DDI) is common among the elderly, and it can have detrimental effects on patients. However, how DDI can be targeted has been under-researched. This study investigates whether DDI can be reduced by targeting continuity of care (COC) through reducing polypharmacy. Population claims data of Taiwan National Health Insurance were used to conduct a 7-year-long longitudinal study on patients aged ≥ 65 years (n = 2,318,766). Mediation analysis with counterfactual method and a 4-way decomposition of the effect of COC on DDI was conducted. Mediation effect through excessive polypharmacy differed from that through lower-level polypharmacy. Compared with the low COC group, the high COC group demonstrated reduced excess relative risk of DDI by 26% (excess relative risk =  − 0.263; 95% Confidence Interval (CI) =  − 0.263 to − 0.259) to 30% (excess relative risk =  − 0.297; 95% CI =  − 0.300 to − 0.295) with excessive polypharmacy as the mediator. The risk only reduced by 8% (excess relative risk =  − 0.079; 95% CI, − 0.08 to − 0.078) to 10% (excess relative risk =  − 0.096; 95% CI, − 0.097 to − 0.095) when the mediator was changed to lower-level polypharmacy. The effect of COC on DDI was mediated by polypharmacy, and the mediation effect was higher with excessive polypharmacy. Therefore, to reduce DDI in the elderly population, different policy interventions should be designed by considering polypharmacy levels to maximize the positive effect of COC on DDI.

scholarly journals The Prevalence of Drug-Drug Interaction and Inappropriate Drug Prescription Among the Elderly in Kashan

2019 ◽  
pp. 183-192
Author(s):  
Mansour Dianati ◽  
Neda Mirbagher Ajorpaz ◽  
Mohammad Sajjad Lotfi ◽  
Maryam Najarzadeh
Keyword(s):  
Drug Interaction ◽  
Drug Prescription ◽  
The Elderly ◽  
Inappropriate Drug ◽  
Drug Drug Interaction

scholarly journals Drug–drug interaction profile of components of a fixed combination of netupitant and palonosetron: Review of clinical data

2015 ◽  
Vol 22 (3) ◽  
pp. 485-495 ◽  
Author(s):  
James J Natale ◽  
Tulla Spinelli ◽  
Selma Calcagnile ◽  
Corinna Lanzarotti ◽  
Giorgia Rossi ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Clinical Data ◽  
Fixed Combination ◽  
Drug Drug Interaction
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