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Potential herb–drug interactions in community-dwelling older adults in China: the Shanghai Aging Study

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Abstract

Background

Potential herb–drug interactions (pHDIs) often go unrecognized, and little is known about the prevalence of pHDIs in older adults.

Aims

This study aimed to investigate the prevalence of pHDIs in community-dwelling older adults in Shanghai and identify patterns and factors associated with pHDIs.

Methods

Baseline data from the Shanghai Aging Study, which was designed to establish a prospective community-based cohort of older adults in Shanghai, were analyzed regarding pHDIs with Lexi-Interact Online software.

Results

Among 1227 participants who used any combination of drug–herb or herb–herb, 43.3% were exposed to at least one pHDI. A total of 1641 different pHDIs were identified among the study samples. Only seven (0.4%) pHDIs were rated as risk category X, indicating that the combinations were contraindicated and should be avoided. Worryingly, 876 (53.4%) pHDIs were rated as risk category D, indicating that significant interactions may occur and therapeutic modification should be considered. Of particular concern is that 99.8% of pHDIs in risk category D involve herbs with anticoagulant/antiplatelet properties. Individuals with stroke (odds ratio [OR] 2.02), hyperlipidemia (OR 1.51) or heart diseases (OR 1.42) and the number of herbs (2.66), number of drugs (OR 1.21), and age (OR 1.02) were significantly associated with the risk of pHDIs.

Conclusion

43.3% of community-dwelling older adults who used any combination of drug–herb or herb–herb was exposed to pHDIs, and more than half of pHDIs were related to herbs with anticoagulant/antiplatelet properties. Awareness of the patterns and high-risk groups of these pHDIs may contribute to increased patient safety.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all the participants in the present study. All authors critically reviewed and approved the final version of the manuscript.

Funding

This study was funded by National Natural Science Foundation of China [81773513], National Natural Science Foundation of China [81872938], National Chronic Disease Project (2016YFC1306402), Scientific Research Plan Project of Shanghai Science and Technology Committee [17411950701, 17411950106], and Shanghai Municipal Science and Technology Major Project [2018SHZDZX01].

Author information

Authors and Affiliations

  1. Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China

    Danyi Chi & Bin Wang

  2. Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China

    Ding Ding, Qianhua Zhao, Xiaoniu Liang & Wanqing Wu

  3. National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China

    Ding Ding, Qianhua Zhao, Xiaoniu Liang & Wanqing Wu

  4. Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China

    Jianfeng Luo

Authors
  1. Danyi Chi
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  2. Ding Ding
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  3. Qianhua Zhao
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  4. Xiaoniu Liang
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  5. Wanqing Wu
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  6. Jianfeng Luo
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  7. Bin Wang
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Contributions

DC, DD, BW were involved in the study concept and design, analysis and interpretation of data; QZ, XL, WW, JL were involved in the acquisition of data. All authors participated in critical revision of the manuscript, contributed comments and approved the final version.

Corresponding authors

Correspondence to Ding Ding or Bin Wang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Medical Ethics Committee of Huashan Hospital, Fudan University, Shanghai, China) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chi, D., Ding, D., Zhao, Q. et al. Potential herb–drug interactions in community-dwelling older adults in China: the Shanghai Aging Study. Aging Clin Exp Res 32, 2677–2685 (2020). https://doi.org/10.1007/s40520-020-01489-0

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  • DOI: https://doi.org/10.1007/s40520-020-01489-0

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