TY - JOUR
T1 - Adverse drug reactions caused by drug-drug interactions in elderly outpatients
T2 - A prospective cohort study
AU - Obreli-Neto, Paulo Roque
AU - Nobili, Alessandro
AU - De Oliveira Baldoni, André
AU - Guidoni, Camilo Molino
AU - De Lyra, Divaldo Pereira
AU - Pilger, Diogo
AU - Duzanski, Juliano
AU - Tettamanti, Mauro
AU - Cruciol-Souza, Joice Mara
AU - Gaeti, Walderez Penteado
AU - Cuman, Roberto Kenji Nakamura
PY - 2012/12
Y1 - 2012/12
N2 - Purpose Although the prevalence of drug-drug interactions (DDIs) in elderly outpatients is high, many potential DDIs do not have any actual clinical effect, and data on the occurrence of DDI-related adverse drug reactions (ADRs) in elderly outpatients are scarce. This study aimed to determine the incidence and characteristics of DDI-related ADRs among elderly outpatients as well as the factors associated with these reactions. Methods A prospective cohort study was conducted between 1 November 2010 and 31 November 2011 in the primary public health system of the Ourinhos microregion, Brazil. Patients aged ≥60 years with at least one potential DDI were eligible for inclusion. Causality, severity, and preventability of the DDI-related ADRs were assessed independently by four clinicians using validated methods; data were analysed using descriptive analysis and multiple logistic regression. Results A total of 433 patients completed the study. The incidence of DDI-related ADRs was 6 % (n030). Warfarin was the most commonly involved drug (37%cases), followed by acetylsalicylic acid (17 %), digoxin (17 %), and spironolactone (17 %). Gastrointestinal bleeding occurred in 37 % of the DDI-related ADR cases, followed by hyperkalemia (17 %) and myopathy (13 %). The multiple logistic regression showed that age ≥80 years [odds ratio (OR) 4.4; 95 % confidence interval (CI) 3.0-6.1, p
AB - Purpose Although the prevalence of drug-drug interactions (DDIs) in elderly outpatients is high, many potential DDIs do not have any actual clinical effect, and data on the occurrence of DDI-related adverse drug reactions (ADRs) in elderly outpatients are scarce. This study aimed to determine the incidence and characteristics of DDI-related ADRs among elderly outpatients as well as the factors associated with these reactions. Methods A prospective cohort study was conducted between 1 November 2010 and 31 November 2011 in the primary public health system of the Ourinhos microregion, Brazil. Patients aged ≥60 years with at least one potential DDI were eligible for inclusion. Causality, severity, and preventability of the DDI-related ADRs were assessed independently by four clinicians using validated methods; data were analysed using descriptive analysis and multiple logistic regression. Results A total of 433 patients completed the study. The incidence of DDI-related ADRs was 6 % (n030). Warfarin was the most commonly involved drug (37%cases), followed by acetylsalicylic acid (17 %), digoxin (17 %), and spironolactone (17 %). Gastrointestinal bleeding occurred in 37 % of the DDI-related ADR cases, followed by hyperkalemia (17 %) and myopathy (13 %). The multiple logistic regression showed that age ≥80 years [odds ratio (OR) 4.4; 95 % confidence interval (CI) 3.0-6.1, p
KW - Age
KW - Cohort studies
KW - Drug interactions
KW - Drug toxicity
KW - Outpatients
KW - Pharmacovigilance
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U2 - 10.1007/s00228-012-1309-3
DO - 10.1007/s00228-012-1309-3
M3 - Article
C2 - 22644345
AN - SCOPUS:84871285571
VL - 68
SP - 1667
EP - 1676
JO - European Journal of Clinical Pharmacology
JF - European Journal of Clinical Pharmacology
SN - 0031-6970
IS - 12
ER -