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Frequency and nature of potential drug–drug interaction in medical wards: a cross-sectional study in a teaching hospital

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Abstract

Background

The safety and proper utilization of a drug depends not only on its pharmacological action, but also its interactions with other drugs and their metabolites. Therefore, a multifaceted biochemical system must be considered when prescribing any drug.

Objective

The purpose of the present study is to identify potential drug–drug interactions (pDDIs) and investigate their level of severity, onset of action, mechanism of action, and incidence in the medical wards of Benazir Bhutto Shaheed Teaching Hospital, Abbottabad, Pakistan.

Methods

A prospective cross-sectional study was conducted from November 2016 to January 2017 in the medical wards of a teaching hospital. A systematic random sampling technique was used to select patients from the available settings with one in every seven patients selected to provide a sample of 384 patients.

Results

A total of 388 pDDIs were identified, which comprised 86 types of drug combinations. Across all pDDIs, most were of major severity (39.9%), followed by moderate (39.6%) and minor (19.5%) severity and contraindicated (0.7%). A majority of the study participants were male (292; 76%) and the mean age of the patients was 50 years. Overall, 51.0% patients had at least one pDDI.

Conclusion

The overall prevalence of pDDIs is very high in medical wards, and the incidence of pDDIs is primarily associated with polypharmacy and patient age.

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References

  1. Murtaza G, Khan MYG, Azhar S, et al. Assessment of potential drug–drug interactions and its associated factors in the hospitalized cardiac patients. Saudi Pharm J. 2016;24(2):220–5.

    Article  Google Scholar 

  2. Dai D, Feinstein JA, Morrison W, et al. Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in intensive care units of US children’s Hospitals. Pediatr Crit Care Med. 2016;17(5):e218.

    Article  Google Scholar 

  3. Rao C, Shenoy V, Udaykumar P. Potential drug–drug interactions in the pediatric intensive care unit of a tertiary care hospital. J Pharmacol Pharmacother. 2019;10(2):63.

    Article  Google Scholar 

  4. Krähenbühl-Melcher A, Schlienger R, Lampert M, et al. Drug-related problems in hospitals. Drug Saf. 2007;30(5):379–407.

    Article  Google Scholar 

  5. Rodvold KA, Kraus DM. Drug interactions involving anti-infective agents. In: Finch RG, Greenwood D, Norrby SR, Whitley RJ, editors. Antibiotic and chemotherapy: anti-infective agents and their use in therapy. 9th ed. Chatham: Churchill Livingstone; 2010. p. 68–103.

    Chapter  Google Scholar 

  6. Van Roon EN, Flikweert S, le Comte M, et al. Clinical relevance of drug–drug interactions. Drug Saf. 2005;28(12):1131–9.

    Article  Google Scholar 

  7. Akbar J, Munir AB, Qamar-uz-Zaman M, et al. Potential drug–drug interactions; a study among patients of intensive care unit (ICU) of a tertiary care hospital of South Punjab, Pakistan. J Pharm Pharm Sci. 2019;7(2):78–83.

    Google Scholar 

  8. Ismail M, Iqbal Z, Khattak MB, et al. Potential drug-drug interactions in internal medicine wards in hospital setting in Pakistan. Int J Clin Pharm. 2013;35(3):455–62.

    Article  CAS  Google Scholar 

  9. Ismail M, Noor S, Harram U, et al. Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study. BMC Health Serv Res. 2018;18(1):762.

    Article  Google Scholar 

  10. Jia J, Zhu F, Ma X, et al. Mechanisms of drug combinations: interaction and network perspectives. Nat Rev Drug Discov. 2009;8(2):111–28.

    Article  CAS  Google Scholar 

  11. Swathi V, Lavanya B, Spandana B, et al. Identification of major drug-drug interactions at tertiary care hospital. Indian J Appl Res. 2019;9(6):42–4.

    Google Scholar 

  12. Zwart-van Rijkom JE, Uijtendaal EV, Ten Berg MJ, et al. Frequency and nature of drug–drug interactions in a Dutch university hospital. Br J Clin Pharmacol. 2009;68(2):187–93.

    Article  CAS  Google Scholar 

  13. Bhagavathula AS, Berhanie A, Tigistu H, et al. Prevalence of potential drug-drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia. Asian Pac J Trop Biomed. 2014;4:S204–8.

    Article  Google Scholar 

  14. Şimşek A, Macit Ç, Taner N, et al. The importance of computerized drug interaction checker programs to avoid potential drug-drug interactions used in community pharmacies: a preliminary study with clarithromycin. Istanb Med J. 2018;19(3).

  15. Şimşek A, Taner N, Macit Ç, et al. The importance of computerized drug interaction checker programs used in community pharmacies to avoid potential drug interactions: a preliminary study with clarithromycin. Istanb Med J. 2019;20(1):67–71.

    Article  Google Scholar 

  16. Micromedex Database. Greenwood village: Truven health analytics. https://www.micromedexsolutions.com/micromedex2/librarian. Accessed 15 Mar 2018.

  17. Muhammad N, Afridi R. Prevalence, types and predictors of potential drug–drug interactions in an internal medicine ward of the Mardan Medical Complex, Mardan, Kpk, Pakistan. Int J Basic Med Sci Pharm. 2017;6(2):28–32.

    Google Scholar 

  18. de Carvalho RE, Reis AM, de Faria LM, et al. Prevalence of drug interactions in intensive care units in Brazil. Acta Paulista Enfermagem. 2013;26(2):150–7.

    Article  Google Scholar 

  19. El Samia Mohamed S, Gad Z, El-Nimr N, et al. Prevalence and pattern of potential drug–drug interactions in the critical care units of a tertiary hospital in Alexandria, Egypt. Adv Pharmacoepidemiol Drug Saf. 2013;2(144):2167–252.

    Google Scholar 

  20. Reimche L, Forster AJ, van Walraven C. Incidence and contributors to potential drug–drug interactions in hospitalized patients. J Clin Pharmacol. 2011;51(7):1043–50.

    Article  CAS  Google Scholar 

  21. Shareef J, Menezes SL, Bhat T. A study on potential drug–drug interactions in medicine department of a multi specialty teaching hospital. J Drug Deliv Ther. 2017;7(6):81–7.

    Google Scholar 

  22. Ahmad A, Khan MU, Haque I, et al. Evaluation of potential drug–drug interactions in general medicine ward of teaching hospital in southern India. J Clin Diagn Res. 2015;9(2):FC10.

    PubMed  PubMed Central  Google Scholar 

  23. Diksis N, Melaku T, Assefa D, et al. Potential drug-drug interactions and associated factors among hospitalized cardiac patients at Jimma University Medical Center, Southwest Ethiopia. SAGE Open Med. 2019;7:2050312119857353.

    Article  Google Scholar 

  24. Kumaraswamy R, Ramani J, Ramesh B, et al. Prevalence of polypharmacy and drug to drug interactions in a tertiary care teaching hospital. Int Res J Pharm. 2014;5(10):778–82.

    Article  Google Scholar 

  25. Kaliamurthy K, Kumar A, Punniyakotti S, et al. Study of drug-drug interactions in general medicine department of a tertiary care hospital. J Appl Pharm Sci. 2015;5(12):122–4.

    Article  CAS  Google Scholar 

  26. Tesfaye ZT, Nedi T. Potential drug–drug interactions in inpatients treated at the internal medicine ward of Tikur Anbessa Specialized Hospital. Drug Healthc Patient Saf. 2017;9:71–6.

    Article  CAS  Google Scholar 

  27. Bajracharya N, Swaroop AM, Rajalekshmi SG, et al. Incidence of drug-drug interactions among patients admitted to the department of general medicine in a tertiary care hospital. J Young Pharm. 2018;10(4):450–5.

    Article  Google Scholar 

  28. Jimmy O, ShobhaRani R, Indira R, et al. Study of drug-drug interactions in the medication charts in medicine wards at a tertiary care hospital, Bangalore. Indian J Pharm Pract. 2012;5(4):61–4.

    Google Scholar 

  29. Getachew H, Assen M, Dula F, et al. Potential drug–drug interactions in pediatric wards of Gondar University Hospital, Ethiopia: a cross sectional study. Asian Pac J Trop Biomed. 2016;6(6):534–8.

    Article  Google Scholar 

  30. Santibáñez C, Roque J, Morales G, et al. Characteristics of drug interactions in a pediatric intensive care unit. Rev Chil Pediatr. 2014;85(5):546–53.

    Article  Google Scholar 

  31. Vonbach P, Dubied A, Krähenbühl S, et al. Prevalence of drug–drug interactions at hospital entry and during hospital stay of patients in internal medicine. Eur J Inter Med. 2008;19(6):413–20.

    Article  Google Scholar 

  32. Shakeel F, Aamir M, Khan AF, et al. Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan. BMC Pharmacol Toxicol. 2018;19(1):85.

    Article  Google Scholar 

  33. Shalavadi M, Chandrashekhar V, Manohar K, et al. A prospective study on prescription pattern of antihypertensive drugs and drug interactions at a tertiary care teaching hospital. Am J Pharmacol. 2018;1(2):1010.

    Google Scholar 

  34. Vonbach P, Dubied A, Krähenbühl S, et al. Evaluation of frequently used drug interaction screening programs. Pharm World Sci. 2008;30(4):367–74.

    Article  Google Scholar 

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Acknowledgements

The authors are thankful to the medical superintendent of the Benazir Bhutto Shaheed Hospital (BBSH), Abbottabad, Pakistan for providing facilities and co-operation during this study and also to the patients who gave their informed consent.

Author information

Authors and Affiliations

  1. Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan

    Tariq Khan, Khayal Muhammad & Fazal Subhan

  2. College of Pharmacy, Margalla Institute of Health Sciences, Rawalpindi, Pakistan

    Nisar Ur Rehman

  3. Department of Pharmacy Practice, Quaid-i-Azam University, Islamabad, Pakistan

    Zakir Khan

Authors
  1. Tariq Khan
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  2. Khayal Muhammad
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  3. Fazal Subhan
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  4. Zakir Khan
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  5. Nisar Ur Rehman
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Contributions

TK, KM, and NUR were involved in the concept, design, and data collection of the study. FS and ZK carried out the statistical analysis. All authors were involved in the interpretation of the data. TK wrote the first draft of the manuscript, and all authors contributed to subsequent drafts.

Corresponding author

Correspondence to Nisar Ur Rehman.

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Funding

The study was not funded.

Conflict of interest

Tariq Khan, Khayal Muhammad, Fazal Subhan, Zakir Khan, and Nisar-Ur-Rehman declare no potential conflicts of interest related to the content of this study.

Ethical approval

Ethical approval was granted by the ethical committee of COMSATS University Islamabad, Abbottabad campus. Approval was also received from the Medical superintendent of BBSH Abbottabad (ref. no. 1123/09-2016).

Consent

The purpose and protocols of the study were explained to patients, and written or oral consent was obtained.

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Khan, T., Muhammad, K., Subhan, F. et al. Frequency and nature of potential drug–drug interaction in medical wards: a cross-sectional study in a teaching hospital. Drugs Ther Perspect 36, 158–165 (2020). https://doi.org/10.1007/s40267-020-00710-4

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  • DOI: https://doi.org/10.1007/s40267-020-00710-4

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