13 research outputs found
Potential drug-drug interactions on in-patient medication prescriptions at Mbarara Regional Referral Hospital (MRRH) in western Uganda: prevalence, clinical importance and associated factors
Background: Drug-drug interactions (DDIs) are an important cause of
adverse drug reactions. The pharmacoepidemiology of such interactions
in hospitals in Uganda is not known. Objectives: To determine the
prevalence, clinical importance and factors associated with potential
DDIs at Mbarara Regional Referral Hospital (MRRH), western Uganda.
Methods: Retrospective analysis of 235 randomly selected
hospitalization episodes (medication charts and medical notes) from
MRRH over a 1-year period from January to December 2008. We collected
data on demographics, medications, principal diagnosis, co-morbid
conditions and the length of hospital stay. Epocrates Rx® was used
to identify and classify potential DDIs according to mechanism and
management strategy. Descriptive statistics were generated and logistic
regression used to determine associated factors. Results: Overall
prevalence of potential DDIs was approximately 23% (54 medication
charts with at least one potential DDI out of 235 hospitalization
episodes). Majority were postulated to occur through a pharmacodynamic
mechanism (10.6%) and most required either "use with caution" (11.9%)
or "modify treatment/monitor" (10.6%) as a suggested management
strategy. After adjusting for confounders: age, sex, hospital
department and number of co-morbid conditions, a principal diagnosis of
a cardiovascular disease (OR 6.52 95% CI 1.32-32.14) and having 4 or
more medicines on the chart (OR 4.30 95% CI 1.98-9.34) were associated
with the presence of a potential DDI. Conclusion: Potential DDIs
frequently occur at MRRH although most are not clinically significant.
Patients with cardiovascular diseases and those who are prescribed
multiple medications need to be monitored more closely