Article Template
Certificate SINTA
Video Tutorial
* Corresponding Author
Polypharmacy, Drug-drug Interaction and Potentially Inappropriate Medication in Hospitalized Elderly Patients with Cardiovascular Diseases in Wangaya Hospital
https://doi.org/10.22146/farmaseutik.v21i2.93730 Ana Maulida Septiani(1), Fita Rahmawati(2*)
(1) Master of Clinical Pharmacy, Faculty of Pharmacy, Gadjah Mada University
(2) Departement of Pharmacology and Clinical pharmacy, Faculty of Pharmacy, Universitas Gadjah
(*) Corresponding Author
Abstract
Cardiovascular diseases (CVDs) are common diseases in the elderly as aging can cause changes in the heart and blood vessels. Patients with CVD are prone to multimorbid conditions which lead to the use of multiple medications (polypharmacy). Polypharmacy is susceptible to drug-drug interaction (DDI) and potentially inappropriate medication (PIM). This study aimed to identify polypharmacy, DDI, and PIM in hospitalized elderly patients with CVD. The design of this study is retrospective cross-sectional. A number of 100 medical records were employed and analyzed descriptively. Polypharmacy is defined as administering multiple medications at the same time or excessive medication administration of ≥4 drugs or ≥5 drugs. Potential DDI was detected by Lexicomp Application. PIM was identified based on Beers criteria 2019. The findings showed that most patients were male (55%) and aged 60-70 (72%). Most of the patients (48%) were categorized as moderate polypharmacy (8-10 medications/day). Potential DDI was revealed in 97% of patients, and Beers Criteria 2019 identified 280 cases of PIM. The study showed that polypharmacy, DDI, and PIM frequently occurred in hospitalized elderly patients with CVD. Pharmacists should pay more attention to reviewing the prescription. Therefore, the process of pharmacotherapy can be optimized and increase safety for elderly patients with CVDs.
Keywords
Full Text:
PDFReferences
Badan Pusat Statistik, Statistik Penduduk Lanjut Usia. Jakarta. Badan Pusat Statistik. 2020.
Błeszyńska E, Wierucki L, Zdrojewski T, Renke M. Pharmacological Interactions in the Elderly. Medicina. 2020;56(7):1-11. doi:10.3390/MEDICINA56070320.
Chande AS, Kumar S, Agrawal SR. Symptomatic Bradycardia-An Offbeat Side Effect of Clonidine in Antihypertensive Dose. Journal of Evolution of Medical and Dental Sciences. 2021;10(4):248-250.
Chang SP, Lee HZ, Lai CC, Tang HJ. The efficacy and safety of nemonoxacin compared with levofloxacin in the treatment of community-acquired pneumonia: a systemic review and meta-analysis of randomized controlled trials. Infection and drug resistance. 2019;12:433-438. doi:10.2147/IDR.S193233.
Davies EA, O’Mahony MS. Adverse drug reactions in special populations - the elderly. British journal of clinical pharmacology. 2015;80(4):796-807. doi:10.1111/BCP.12596.
De Oliveira LM, Diel JDAC, Nunes A, Da Silva Dal Pizzol T. Prevalence of drug interactions in hospitalised elderly patients: a systematic review. European journal of hospital pharmacy : science and practice. 2021;28(1):4-9. doi:10.1136/EJHPHARM-2019-002111.
DeGeorge KC, Ring DJ, Dalrymple SN. Treatment of the Common Cold. American Family Physician. 2019;100(5):281-289.
Forgerini M, Mieli S, Mastroianni P de C. Safety assessment of omeprazole use: a review. Sao Paulo medical journal = Revista paulista de medicina. 2018;136(6):557-570. doi:10.1590/1516-3180.2018.0019220318.
Gao Z, Chen Z, Sun A, Deng X. Gender differences in cardiovascular disease. Medicine in Novel Technology and Devices. 2019;4:100025. doi:10.1016/J.MEDNTD.2019.100025.
Horodinschi RN, Stanescu AMA, Bratu OG, Stoian AP, Radavoi DG, Diaconu CC. Treatment with Statins in Elderly Patients. Medicina (Kaunas, Lithuania). 2019;55(11). doi:10.3390/MEDICINA55110721.
Hulley S, Cummings S, Browner W, Grady D, Newman T. Designing Clinical Research: An Epidemiologic Approach. In: Fourth Edition. Philadelphia: Lippincott Williams & Wilkins; 2013.
Izquierdo-Alonso JL, Pérez-Rial S, Rivera CG, Peces-Barba G. N-acetylcysteine for prevention and treatment of COVID-19: Current state of evidence and future directions. Journal of infection and public health. 2022;15(12):1477-1483. doi:10.1016/J.JIPH.2022.11.009.
Jain N, Susan Hedayati S, Sarode R, Banerjee S, Reilly RF. Antiplatelet therapy in the management of cardiovascular disease in patients with CKD: what is the evidence? Clinical journal of the American Society of Nephrology : CJASN. 2013;8(4):665-674. doi:10.2215/CJN.06790712.
Khaje-Bishak Y, Payahoo L, Pourghasem B, Jafarabadi MA. Assessing the Quality of Life in Elderly People and Related Factors inTabriz, Iran. Journal of Caring Sciences. 2014;3(4):257. doi:10.5681/JCS.2014.028.
Krishnaswami, A., Steinman, M.A., Goyal, P., Zullo, A.R., Anderson, T.S., Birtcher, K.K. Deprescribing in Older Adults with Cardiovascular Disease. Journal of the American College of Cardiology. 2019. 73: 2584–2595. doi:10.1016/j.jacc.2019.03.467.
Lacy C., Amstrong L., Goldman M., Lance L. Drug Information Handbook 17th Edition. Lexi-Comp. 2008.
Lespessailles E, Toumi H. Proton Pump Inhibitors and Bone Health: An Update Narrative Review. International journal of molecular sciences. 2022;23(18). doi:10.3390/IJMS231810733.
Li M, Wei N, Shi HY, et al. Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months’ follow-up. Journal of Geriatric Cardiology : JGC. 2023;20(7):495. doi:10.26599/1671-5411.2023.07.002.
Montastruc JL, Lafaurie M, de Canecaude C, et al. Fatal adverse drug reactions: A worldwide perspective in the World Health Organization pharmacovigilance database. British Journal of Clinical Pharmacology. 2021;87(11):4334-4340. doi:10.1111/BCP.14851.
Mugada V, Bhagavathi KC, Sagina P, Karnataka K, Ravada S, Kancharapu RM. Potentially inappropriate medications, drug-drug interactions, and prescribing practices in elderly patients: a cross-sectional study. Revista da Associacao Medica Brasileira (1992). 2021;67(6):800-805. doi:10.1590/1806-9282.20200912.
Oscanoa TJ, Lizaraso F, Carvajal A. Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. European journal of clinical pharmacology. 2017;73(6):759-770. doi:10.1007/S00228-017-2225-3.
Passacquale G, Sharma P, Perera D, Ferro A. Antiplatelet therapy in cardiovascular disease: Current status and future directions. British journal of clinical pharmacology. 2022;88(6):2686-2699. doi:10.1111/BCP.15221.
Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. European geriatric medicine. 2021;12(3):443-452. doi:10.1007/S41999-021-00479-3.
Rhee EJ. Prevalence and Current Management of Cardiovascular Risk Factors in Korean Adults Based on Fact Sheets. Endocrinology and metabolism (Seoul, Korea). 2020;35(1):85-94. doi:10.3803/ENM.2020.35.1.85.
Rodrigues, M.C.S. and Oliveira, C. de. Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review. Revista Latino-Americana de Enfermagem, 2016;24. doi: 10.1590/1518-8345.1316.2800.
Schenker Y, Park SY, Jeong K, et al. Associations Between Polypharmacy, Symptom Burden, and Quality of Life in Patients with Advanced, Life-Limiting Illness. Journal of general internal medicine. 2019;34(4):559-566. doi:10.1007/S11606-019-04837-7.
Suman S, Pravalika J, Manjula P, Farooq U. Gender and CVD- Does It Really Matters? Current problems in cardiology. 2023;48(5). doi:10.1016/J.CPCARDIOL.2023.101604.
Tefera YG, Alemayehu M, Mekonnen GB. Prevalence and determinants of polypharmacy in cardiovascular patients attending outpatient clinic in Ethiopia University Hospital. PLoS ONE. 2020;15(6):1-16. doi:10.1371/journal.pone.0234000.
Theis KA, Brady TJ, Helmick CG. No One Dies of Old Age Anymore: A Coordinated Approach to Comorbidities and the Rheumatic Diseases. Arthritis Care and Research. 2017;69(1):1-4. doi:10.1002/ACR.23114.
Veloso RC de SG, de Figueredo TP, Barroso SCC, Do Nascimento MMG, Reis AMM. Factors associated with drug interactions in elderly hospitalized in high complexity hospital. Ciencia & saude coletiva. 2019;24(1):17-26. doi:10.1590/1413-81232018241.32602016.
Whelton PK, Carey RM, Aronow WS, et al. Stable Coronary Artery Disease: Treatment. American Family Physician. 2018;97(6):376-384. doi:10.1016/j.jacc.2017.11.006.
WHO, 2019. Medication Safety in Polypharmacy. URL: https://apps.who.int/iris/ bitstream/handle/10665/325454/WHO-UHC-SDS-2019.11-eng.
Woo SD, Yoon J, Doo GE, et al. Common causes and characteristics of adverse drug reactions in older adults: a retrospective study. BMC Pharmacology and Toxicology. 2020;21(1):1-9. doi:10.1186/S40360-020-00464-9/TABLES/4.
Zazzara MB, Palmer K, Vetrano DL, Carfì A, Graziano O. Adverse drug reactions in older adults: a narrative review of the literature. European geriatric medicine. 2021;12(3):463-473. doi:10.1007/S41999-021-00481-9.
Zhao M, Song JX, Zheng FF, Huang L, Feng YF. Potentially Inappropriate Medication and Associated Factors Among Older Patients with Chronic Coronary Syndrome at Hospital Discharge in Beijing, China. Clinical interventions in aging. 2021;16:1047-1056. doi:10.2147/CIA.S305006.
Zhou L, Rupa AP. Categorization and association analysis of risk factors for adverse drug events. European journal of clinical pharmacology. 2018;74(4):389-404. doi:10.1007/S00228-017-2373-5. DOI: https://doi.org/10.22146/farmaseutik.v21i2.93730
Article Metrics
Abstract views : 420
| 
views : 99
Refbacks
- There are currently no refbacks.
Faculty of Pharmacy
Universitas Gadjah Mada
