Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre
Introduction Antidepressant use has increased over the last two decades, with Australia and New Zealand among the highest antidepressant users in Organisation for Economic Co-operation and Development (OECD) countries. Comorbidity and polypharmacy are common in antidepressant users, increasing the...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
CSIRO Publishing
2022-01-01
|
| Series: | Journal of Primary Health Care |
| Subjects: | |
| Online Access: | https://www.publish.csiro.au/hc/pdf/HC21150 |
| _version_ | 1828161636504961024 |
|---|---|
| author | Treasure M. McGuire Geraldine M. Moses David M. Pache Mieke L. van Driel Samantha A. Hollingworth Hyang Joo Lim Edgar L. Poon |
| author_facet | Treasure M. McGuire Geraldine M. Moses David M. Pache Mieke L. van Driel Samantha A. Hollingworth Hyang Joo Lim Edgar L. Poon |
| author_sort | Treasure M. McGuire |
| collection | DOAJ |
| description |
Introduction
Antidepressant use has increased over the last two decades, with Australia and New Zealand among the highest antidepressant users in Organisation for Economic Co-operation and Development (OECD) countries. Comorbidity and polypharmacy are common in antidepressant users, increasing the likelihood of interaction-related adverse drug events, which are frequently preventable.
Aim
We aimed to identify, profile, and analyse potential antidepressant drug–drug interactions in information-seeking antidepressant users.
Methods
We retrospectively analysed antidepressant-related drug–drug interaction enquiries from patients or carers who contacted a pharmacist-led Australian national medicines call centre over an 8-year period to determine patient characteristics, concomitant drugs involved, prevalence and type of antidepressant-related drug–drug interaction across life stages, and associated risks.
Results
Of 3899 antidepressant drug–drug interaction calls, the most frequent concomitant drugs were antipsychotics, opioids, benzodiazepines, and complementary medicines. Narrative analyses of 2011 calls identified 81.0% of patients with potential drug–drug interactions and 10.4% categorised with worrying symptoms. The most frequent drug–drug interaction risks were excessive sedation, increased anticholinergic effects, serotonin syndrome, and suicidal thoughts. Carers of children aged <15 years and older adults (65–74 years) were more likely to report experiencing worrying symptoms. Although more potential pharmacodynamic than pharmacokinetic interactions were recorded, pharmacokinetic interactions tended to have more significant clinical impact.
Discussion
Antidepressant users often have information gaps and safety concerns regarding drug–drug interactions that motivate help-seeking behaviour. Symptoms and drug–drug interaction consequences may be underestimated in these patients. Primary care health professionals have a role in proactively addressing the risk of drug–drug interactions to support benefit-risk assessment and shared decision-making.
|
| first_indexed | 2024-04-12T00:40:32Z |
| format | Article |
| id | doaj.art-7e0e48a49d0f483eb54173ce03e89bcf |
| institution | Directory Open Access Journal |
| issn | 1172-6156 |
| language | English |
| last_indexed | 2024-04-12T00:40:32Z |
| publishDate | 2022-01-01 |
| publisher | CSIRO Publishing |
| record_format | Article |
| series | Journal of Primary Health Care |
| spelling | doaj.art-7e0e48a49d0f483eb54173ce03e89bcf2022-12-22T03:55:00ZengCSIRO PublishingJournal of Primary Health Care1172-61562022-01-0114299108HC21150Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centreTreasure M. McGuire0Geraldine M. Moses1David M. Pache2Mieke L. van Driel3Samantha A. Hollingworth4Hyang Joo Lim5Edgar L. Poon6School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia; and Mater Pharmacy, Mater Health South East Queenland, Brisbane, Qld, Australia; and Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia.School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia; and Mater Pharmacy, Mater Health South East Queenland, Brisbane, Qld, Australia.School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia; and Mater Pharmacy, Mater Health South East Queenland, Brisbane, Qld, Australia; and Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia.Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia.School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia.School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia; and Mater Pharmacy, Mater Health South East Queenland, Brisbane, Qld, Australia; and Greenslopes Private Hospital, Ramsay Health, Brisbane, Qld, Australia. Introduction Antidepressant use has increased over the last two decades, with Australia and New Zealand among the highest antidepressant users in Organisation for Economic Co-operation and Development (OECD) countries. Comorbidity and polypharmacy are common in antidepressant users, increasing the likelihood of interaction-related adverse drug events, which are frequently preventable. Aim We aimed to identify, profile, and analyse potential antidepressant drug–drug interactions in information-seeking antidepressant users. Methods We retrospectively analysed antidepressant-related drug–drug interaction enquiries from patients or carers who contacted a pharmacist-led Australian national medicines call centre over an 8-year period to determine patient characteristics, concomitant drugs involved, prevalence and type of antidepressant-related drug–drug interaction across life stages, and associated risks. Results Of 3899 antidepressant drug–drug interaction calls, the most frequent concomitant drugs were antipsychotics, opioids, benzodiazepines, and complementary medicines. Narrative analyses of 2011 calls identified 81.0% of patients with potential drug–drug interactions and 10.4% categorised with worrying symptoms. The most frequent drug–drug interaction risks were excessive sedation, increased anticholinergic effects, serotonin syndrome, and suicidal thoughts. Carers of children aged <15 years and older adults (65–74 years) were more likely to report experiencing worrying symptoms. Although more potential pharmacodynamic than pharmacokinetic interactions were recorded, pharmacokinetic interactions tended to have more significant clinical impact. Discussion Antidepressant users often have information gaps and safety concerns regarding drug–drug interactions that motivate help-seeking behaviour. Symptoms and drug–drug interaction consequences may be underestimated in these patients. Primary care health professionals have a role in proactively addressing the risk of drug–drug interactions to support benefit-risk assessment and shared decision-making. https://www.publish.csiro.au/hc/pdf/HC21150Antidepressive agentscall centredrug information servicesdrug interactionshelp-seeking behaviourinformation-seeking behaviour |
| spellingShingle | Treasure M. McGuire Geraldine M. Moses David M. Pache Mieke L. van Driel Samantha A. Hollingworth Hyang Joo Lim Edgar L. Poon Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre Journal of Primary Health Care Antidepressive agents call centre drug information services drug interactions help-seeking behaviour information-seeking behaviour |
| title | Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre |
| title_full | Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre |
| title_fullStr | Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre |
| title_full_unstemmed | Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre |
| title_short | Patient concerns regarding antidepressant drug–drug interactions: a retrospective analysis using data from a medicines call centre |
| title_sort | patient concerns regarding antidepressant drug drug interactions a retrospective analysis using data from a medicines call centre |
| topic | Antidepressive agents call centre drug information services drug interactions help-seeking behaviour information-seeking behaviour |
| url | https://www.publish.csiro.au/hc/pdf/HC21150 |
| work_keys_str_mv | AT treasuremmcguire patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT geraldinemmoses patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT davidmpache patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT miekelvandriel patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT samanthaahollingworth patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT hyangjoolim patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre AT edgarlpoon patientconcernsregardingantidepressantdrugdruginteractionsaretrospectiveanalysisusingdatafromamedicinescallcentre |