Prevalence and clinical significance of potential drug-drug interactions in hypertensive patients in Taiwan
Date Issued
2006
Date
2006
Author(s)
Lin, Mei-Shu
DOI
en-US
Abstract
Background
The coincidence of patients with the more elderly, the high prevalence, combination drug therapy, hepatic metabolisms of antihypertensive drugs and drug-treated comorbid conditions might result in higher possibility of many drug-drug interactions (DDIs) in patients with hypertension. Our study purposes were to estimate prevalence, incidence of hospital admission associated with common potential DDIs and identify the pairings of significance ‘1’ potential DDIs those should be avoided or need dose adjustment for drug safety.
Methods
We used cross-sectional study to estimate the prevalence of potential DDIs and used the retrospective cohort study to estimate the incidence of hospital admission. The data resources were all prescriptions taken by patients with hypertension in the cohort-sampling databases of national health insurance from 1997 through 2001. The potential DDIs induced from the same prescription and different prescriptions were analyzed in this study.
The Logistic regression analysis was used to estimate relative risks of admission incidences. The χP2 Pstatistic was used to evaluate the association of the variables (e.g.,age, sex, number of chronic diseases and of medications). All data were analyzed with SAS 9.1 software (SAS Institute, Cary, NC) and the potential DDIs were selected with SAS-SQL program. All significant test was two-tailed with α = 0.05.
Results
We found 23,925 patients with hypertension in the database. The prevalences of potential DDIs by prescription in general prescriptions and hypertensive prescriptions were reduced yearly and the mean prevalence with 10.5% and 30.5%, respectively. The most common significance ‘1’ potential DDIs those should be avoided was cisapride, especially in the prescriptions from different hospital. The most common significance ‘1’ potential DDIs those need dose adjustment was associated with digoxin. The ratios of potential DDIs were proportional to age, drug items of prescriptions and concomitant numbers of chronic diseases. The most common medications associated with significance ‘2’ potential DDIs were sulfonamide urea derivatives and the admission incidence was 1.71 (95% CI 1.01-2.89).
Conclusions
Patients with hypertension, especially elderly and multiple illness, had higher risk to occur serious adverse drug reaction from potential DDIs. We found the most important source of potential DDIs was the prescriptions from different hospitals. The electronic file of common potential DDIs that we set up could be implemented to the computer system and integrated with the drug history from the network of different hospitals for drug safety.
Subjects
潛在藥品交互作用
盛行率
發生率
hypertension
potential DDIs
prevalence
incidence
Type
thesis