The impact of polypharmacy and drug interactions among the elderly population in Western Sicily, Italy
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Primary endpoint was to report polypharmacy distribution in the general population vs ≥65 years old people and to examine the frequency of drug–drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients’ age.
Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0–13, 14–64, 65–69, 70–74, and ≥75 year old). The detection of potential DDIs in polypharmacy profiles was performed with NavFarma software (Infologic srl, Padova, Italia), with DDI classification provided by tool Micromedex Drug Reax (Truven Health Analitics, Michigan, USA).
We analyzed data of 1,324,641 patients, and 15,801,191 medical prescription were recorded; of these, 11,337,796 regarded chronic conditions. The drug prescriptions reached the highest values in the 65–69 and 70–74 age groups (p = 0.005 and p = 0.008 vs age 14–64 respectively). An overall amount of 6,094,373 DDIs were detected, of which 47,173 were contraindicated. Median number of DDIs was higher in 65–69 and 70–74 age groups (p = 0.008 and p = 0.012 vs age 14–64, respectively). Regarding contraindicated DDIs a significant difference was detected comparing 14–64 vs ≥65 age groups (p = 0.010 vs 65–69 group, p = 0.005 vs 70–74 group and ≥75 group).
Polypharmacy is a phenomenon acquiring increasing dimensions also in our province. It interests particularly the older subjects, and assumes a dramatic accent when it is put in relationship with the frequency of DDIs. A proactive vigilance about potential life threatening drug interactions is mandatory.
KeywordsPolypharmacy Drug interactions Elderly population Drug prescriptions Contraindicated drug–drug interactions
Compliance with ethical standards
GS, SPA, AC designed research; GS, FP, MP, MV performed research; SPA, MF, SS analyzed data; GS, FP, AC wrote the paper.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
The study was approved by the Ethics Committee of the Azienda Ospedaliero-Universitaria Policlinico “Paolo Giaccone” in Palermo, Italy.
- 16.Wajne EJ (1958) In: Walpole AL, Spinks A (eds) The evaluation of drug toxicity. London, Churchill, pp 1–11Google Scholar
- 20.Gómez-Huelgas R, Giner-Galvañ V, Mostaza JM, Cuende JI, de Miguel-Yanes JM, Rovira E, Sánchez-Fuentes D, Suárez Fernández C, Román Sánchez P; SEMI Working Group (2014) Unanswered clinical questions in the management of cardiometabolic risk in the elderly: a statement of the Spanish Society of Internal Medicine. BMC Cardiovasc Disord 14:193CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Onder G, Bonassi S, Abbatecola AM, Folino-Gallo P, Lapi F, Marchionni N, Pani L, Pecorelli S, Sancarlo D, Scuteri A, Trifirò G, Vitale C, Zuccaro SM, Bernabei R, Fini M; Geriatrics Working Group of the Italian Medicines Agency (2014) High prevalence of poor quality drug prescribing in older individuals: a nationwide report from the Italian Medicines Agency (AIFA). J Gerontol A Biol Sci Med Sci 69:430–437CrossRefPubMedGoogle Scholar
- 24.Nobili A, Pasina L (2014) Pharmacological treatment of complex elderly patients: drug interactions. Giornale Italiano di Farmacoeconomia e Farmacoutilizzazione 6:38–45. Website: http://www.sefap.it/web/upload/GIFF3_2014_05_Nobili_ras_1.pdf. Last accessed 29 Nov 2016
- 25.Website: http://www.istat.it/it/sicilia. Last accessed 29 Nov 2016
- 26.Website: http://www.infologic.it/navfarma/territorio/navfarma-perilterritorio.htm. Last accessed 29 Nov 2016
- 31.United Nations, Department of Economic and Social Affairs, Population Division: World population ageing: 1950–2050 (2002) World assembly on ageing. http://www.un.org/esa/population/publications/worldageing19502050/. United Nations Publications, New York. Accessed 29 Nov 2016
- 32.United Nations World Population Ageing 2013 (2013) UN, New YorkGoogle Scholar
- 33.Gruppo Tecnico di Coordinamento del Sistema di Sorveglianza PASSI d’Argento. Luzi P (ed) Sperimentazione PASSI d’Argento (Progressi delle Aziende Sanitarie per la Salute in Italia): verso un sistema nazionale di sorveglianza della popolazione ultra64enne. Roma: Istituto Superiore di Sanità; 2013. (Rapporti ISTISAN 13/9). Website: http://www.iss.it/binary/publ/cont/13_9_web.pdf. Last accessed 29 Nov 2016