Assessment of potential drug-drug interactions among outpatients receiving cardiovascular medications at Jimma University specialized hospital, South West Ethiopia

Legese Chelkeba, Fessahaye Alemseged, Worku Bedada

Abstract


Background: The quality of pharmacotherapy is highly dependent on the process of choosing a drug in relation to nature of the disease. Several factors should be considered in choosing optimal pharmacotherapeutics strategy including efficacy, safety, availability and cost of the drugs. The objective of this study was to assess potential drug-drug interactions and risk factors in outpatients taking cardiovascular drugs at Jimma University specialized hospital.

Methods: A cross-sectional study was conducted from Feb. to April, 2011on patients visiting the cardiac clinic of Jimma University Specialized hospital. A sample of 332 outpatients who were taking cardiovascular medications at study clinic was studied. MicroMedex software was used to screen drug-drug interactions and SPSS for windows software versions-16.0 was used for data analysis.

Results: A total of 1249 drugs with average of 3.76 drugs per prescription were prescribed for the 332 patients. The frequency of potential DDIs was found to be 241 (72.6%). Among these 200 (67.3%) were of "moderate" severity and 164 (55.2%) were delayed in onset. The most common potential DDI observed was between Enalapril and Furosemide (20%). Patients who prescribed many drugs (AOR=4.09; P=0.00) by medical intern had a higher risk of developing potential DDIs (AOR=4.6; P=0.00).

Conclusions: Patients with cardiovascular disorders are subjected to high risk of potential drug-drug interactions and the number of drugs prescribed and educational level of the prescribers has a high significantly associated with the occurrence of potential drug-drug interactions. Therefore, it is imperative that further studies need to be conducted to identify reasons for and tackle the problem and provide appropriate mechanisms for management.


Keywords


Drug-drug interactions, Cardiovascular, Outpatients

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References


Patel VK, Acharya LD, Rajakannan T, Surulivelrajan M, Guddattu V, Padmakumar R. Potential drug interactions in patients admitted to cardiology wards of a south Indian teaching hospital. Australas Med J 2011;4:9-14.

Hussar DA. Drug interaction. In: GennaroL, Marderosian A, Hanson G et al. Remington The science and practice of pharmacy. Philadelphia: seventh edition: Lippincott Williams and Willinks 2007; 1746-61.

Carter BL, Lund BC, Hayase N, and Chrischilles E. The extent of potential antihypertensive drug interactions in a Medicaid population. Am J Hypertens 2002;15:953-7.

Bista D, Palaian S, Shankar P. Understanding the essentials of drug interactions: A potential need for safe and effective use of drugs. Kathmandu Univ Med J 2006:4:421-30.

Costa AJ. Potential drug interactions in an ambulatory geriatric population. Fam Pract 1991;8:234-6.

Lindblad CI, Artz MB, Pieper CF, Sloane RJ, Hajjar ER, Ruby CM, SchmaderKE, Nalón JT. Potential drug-disease interactions in frail, hospitalized elderly veterans. Ann Pharmacother 2005,39:412-7.

Janchawee B, Wongpoowarak W, Owatranporn T, Chongsuvivatwong V. Pharmacoepidemiology study of potential drug interactions in outpatients of a university hospital in Thailand. J Clin Pharm Ther 2005;30:13-20.

Doubova (Dubova) SV, Morales HR, Arreola LT, Ortega MS. Potential drug-drug and drug-disease interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in Mexico City. BMC Health Serv Res 2007,7:147.

Vrca VB, Marusic S, Erdeljic V, Falamic S, Tomic NG, Rahelic D. The incidence of potential DDIs in elderly patients with arterial hypertension. Pharm World Sci 2010;4:1-7.

Sweileh W. Extent of potential interactions among patients receiving anti-hypertensive medications. Saudi Med J 2005;26:548-52.

Egger SS, Ratz Bravo AE, Hess L, Schlienger RG, Krahenbuhl S. Age-related differences in the prevalence of potential drug-drug interactions in ambulatory dyslipidaemic patients treated with statins. Drugs Aging 2007;24:429-40.

Souza JM, Thomson JC. Pharmacoepidemiology study of DIs in a Brazil teaching hospital. Clinics 2006;61:515-20.

Linnarsson R. Drug interactions in primary health care; a retrospective database study and its implications for the design of a computerized decision support system. Scand J Prim Health Care 1993;11:181-6.

Straubhaar B, Krahenbuhl S, Schlienger RG. Prevalence of potential drug interaction in patients with heart failure at hospital discharge. Drug Saf 2006;29:79-90.

Buurma H, De Smet PA, Egberts AC. Clinical Risk Management in Dutch Community Pharmacies; the Case of Drug-Drug Interactions. Drug Saf 2006;29:723-32.

Magro L, Conforti A, Del Zotti F, Leone R, Iorio ML, Meneghelli I, et al. Identification of severe potential drug-drug interactions using an Italian general-practitioner database. Eur J Clin Pharmacol 2008;64:303-9.