Potential drug–drug interactions in oncological adult inpatients at a Spanish hospital: epidemiology and risk factors

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015. This document is the Published version of a Published Work that appeared in final form in International Journal of Clinical Pharmacy. To access the final edited and published work see https://doi.org/10.1007/s11096-015-0195-zBackground Oncological patients are at high risk for drug–drug interactions (DDIs), which may contribute to therapeutic failure or lead to serious adverse events. Objective To determine the prevalence of potential DDIs in medication lists, to describe the most frequent DDIs and to investigate the possible risk factors associated with them. A prospective cohort study was performed at the Oncology Department of a tertiary hospital over a 12-week period. Twice a week, every inpatient’s treatment sheet was collected and screened through two databases: Micromedex™ and Drug Interaction Facts™. All identified potential DDIs with a moderate or higher severity rating were recorded. Multivariate analysis was used to identify risk factors associated with DDIs. Result A total of 1956 DDIs were detected in 699 treatment sheets. The prevalence of treatment sheets with DDIs was 81.0 % and 32.6 % by Micromedex™ and Drug Interaction Facts™, respectively. Central nervous depressant agents and antiemetics were the most commonly involved groups in DDIs. A higher number of non-antineoplastic drugs was related with potential DDIs [adjusted-OR 1.398 and 1.613 by Micromedex™ and Drug Interaction Facts™, respectively]. Conclusion The prevalence of potential DDIs was widely variable among databases. The main risk factor associated with DDIs was a higher number of non-antineoplastic medicines

Treatment adherence in patients older than 65 years who suffer early readmissions

Objective: Analyze the frequency of therapeutic noncompliance in patients who suffer early readmissions, and identify the factors associated with it. Method: Observational, descriptive study of three months duration (March - May 2014). All patients older than 65 years who readmitted in the 3-30 days following the last hospital discharge were included. We excluded programmed re-admissions and readmissions in the Intensive Care Unit. The variables collected were: age, sex, medical service, major diagnostic category, polypharmacy, number of days since the last hospital discharge, presence of hypertension and/or diabetes. The therapeutic compliance and the difficulty in the administration of medication were evaluated by means of the Morisky-Green test and the Haynes-Sackett test respectively. A descriptive analysis of the variables was carried out and they were related to the therapeutic adherence. The variables with statistical significance were included in a multivariate logistic regression model. Results: Fifty seven percent of the patients presented lack of adherence to pharmacological treatment. Twenty three percent had difficulty administering the medication. Eighty six percent had comorbidities (hypertension and/or diabetes) and 79% had a caregiver. Eighty six percent of patients were polymedicated (≥ 5 drugs). There is a relationship between lack of adherence and difficulty in the administration of medications (p=0.021), polypharmacy (p=0.002), and the presence of diabetes mellitus (p=0.018). Conclusions: Polymedication, the presence of diabetes mellitus and the existence of difficulty in the administration of medication are evidenced as prognostic factors of the lack of adherence to treatment in patients older than 65 years