Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region
Backround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies.Methods: We defined...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2020.624888/full |
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| author | Sofia Burato Luca Leonardi Ippazio Cosimo Antonazzo Emanuel Raschi Chiara Ajolfi Manuela Baraghini Antonella Chiarello Antonella Chiarello Valentina Delmonte Lucio Di Castri Monia Donati Antonella Fadda Daniela Fedele Alessandra Ferretti Laura Gabrielli Silvia Gobbi Sereno Lughi Martina Mazzari Fabio Pieraccini Alessandro Renzetti Elsa Russi Chiara Scanelli Barbara Zanetti Elisabetta Poluzzi Elisabetta Poluzzi |
| author_facet | Sofia Burato Luca Leonardi Ippazio Cosimo Antonazzo Emanuel Raschi Chiara Ajolfi Manuela Baraghini Antonella Chiarello Antonella Chiarello Valentina Delmonte Lucio Di Castri Monia Donati Antonella Fadda Daniela Fedele Alessandra Ferretti Laura Gabrielli Silvia Gobbi Sereno Lughi Martina Mazzari Fabio Pieraccini Alessandro Renzetti Elsa Russi Chiara Scanelli Barbara Zanetti Elisabetta Poluzzi Elisabetta Poluzzi |
| author_sort | Sofia Burato |
| collection | DOAJ |
| description | Backround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies.Methods: We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 years-old were collected from nine Local Health Authorities of Emilia Romagna: data on community-dwelling subjects were extracted from archives of reimbursed prescriptions, while drug use in a sample of nursing homes was recorded from clinical charts in one index day within the same semester. The frequency of polypharmacy (at least five or at least 10 concurrent drugs) and of each DDI was calculated.Results: In line with different rates of polypharmacy (80% vs 16%), the risk of exposure to at least one interaction was 53.7% in nursing homes and 26.4% in outpatients. Among DDIs, in nursing homes antidepressants—anxiolytics (11.9%) ranked first, followed by antidepressants—aspirin (7.4%). In outpatients, ACE-inhibitors—non-steroidal anti-inflammatory drugs (NSAIDs) reached 7.2% followed by the calcium channel blockers—α-blockers (2.4%).Discussion: Polypharmacy and risk of DDIs appeared very different in the two settings, due to both technical and clinical reasons. In order to reduce use of benzodiazepines, NSAIDs, antidepressants and relevant DDIs, 1) defining alternative options for pain relief in elderly outpatients, and 2) implementing non-pharmacological management of insomnia and anxiety in nursing homes should be prioritized. |
| first_indexed | 2024-12-23T23:23:20Z |
| format | Article |
| id | doaj.art-98803bfb94cd469dadd45a432c177a5e |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-23T23:23:20Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-98803bfb94cd469dadd45a432c177a5e2022-12-21T17:26:16ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-02-011110.3389/fphar.2020.624888624888Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna RegionSofia Burato0Luca Leonardi1Ippazio Cosimo Antonazzo2Emanuel Raschi3Chiara Ajolfi4Manuela Baraghini5Antonella Chiarello6Antonella Chiarello7Valentina Delmonte8Lucio Di Castri9Monia Donati10Antonella Fadda11Daniela Fedele12Alessandra Ferretti13Laura Gabrielli14Silvia Gobbi15Sereno Lughi16Martina Mazzari17Fabio Pieraccini18Alessandro Renzetti19Elsa Russi20Chiara Scanelli21Barbara Zanetti22Elisabetta Poluzzi23Elisabetta Poluzzi24Department of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyPost Graduate School of Hospital Pharmacy, Department of Pharmacy, University of Pisa, Pisa, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyLocal Health Authority of Modena, Modena, ItalyLocal Health Authority of Romagna (Forlì and Cesena Units), Emilia-Romagna, ItalyPost Graduate School of Hospital Pharmacy, Department of Pharmacy, University of Pisa, Pisa, ItalyLocal Health Authority of Imola, Imola, ItalyLocal Health Authority of Parma, Parma, ItalyLocal Health Authority of Piacenza, Piacenza, ItalyLocal Health Authority of Bologna, Bologna, ItalyLocal Health Authority of Imola, Imola, ItalyLocal Health Authority of Ferrara, Ferrara, Italy0Local Health Authority of Reggio Emilia, Reggio Emilia, Italy0Local Health Authority of Reggio Emilia, Reggio Emilia, ItalyLocal Health Authority of Romagna (Forlì and Cesena Units), Emilia-Romagna, ItalyLocal Health Authority of Romagna (Forlì and Cesena Units), Emilia-Romagna, ItalyLocal Health Authority of Piacenza, Piacenza, ItalyLocal Health Authority of Romagna (Forlì and Cesena Units), Emilia-Romagna, ItalyLocal Health Authority of Modena, Modena, ItalyLocal Health Authority of Parma, Parma, Italy1University Hospital of Ferrara, Ferrara, ItalyLocal Health Authority of Bologna, Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy2Centre of Studies and Research on the Elderly, University of Bologna, Bologna, ItalyBackround: We aimed at assessing the prevalence of polypharmacy and potential drug-drug interactions (DDIs) with clinical relevance in elderly patient on Emilia Romagna area. Both outpatients and residents in nursing homes were assessed, with only partially overlapping strategies.Methods: We defined a list of 190 pairs of potentially interacting drugs, based on literature appraisal and availability of therapeutic alternatives. January-June 2018 data on drug use in patients over 65 years-old were collected from nine Local Health Authorities of Emilia Romagna: data on community-dwelling subjects were extracted from archives of reimbursed prescriptions, while drug use in a sample of nursing homes was recorded from clinical charts in one index day within the same semester. The frequency of polypharmacy (at least five or at least 10 concurrent drugs) and of each DDI was calculated.Results: In line with different rates of polypharmacy (80% vs 16%), the risk of exposure to at least one interaction was 53.7% in nursing homes and 26.4% in outpatients. Among DDIs, in nursing homes antidepressants—anxiolytics (11.9%) ranked first, followed by antidepressants—aspirin (7.4%). In outpatients, ACE-inhibitors—non-steroidal anti-inflammatory drugs (NSAIDs) reached 7.2% followed by the calcium channel blockers—α-blockers (2.4%).Discussion: Polypharmacy and risk of DDIs appeared very different in the two settings, due to both technical and clinical reasons. In order to reduce use of benzodiazepines, NSAIDs, antidepressants and relevant DDIs, 1) defining alternative options for pain relief in elderly outpatients, and 2) implementing non-pharmacological management of insomnia and anxiety in nursing homes should be prioritized.https://www.frontiersin.org/articles/10.3389/fphar.2020.624888/fulldrug-drug interactions (DDIs)older peolpedrug utilizationinappropriatenessnursing homecommunity dwelling |
| spellingShingle | Sofia Burato Luca Leonardi Ippazio Cosimo Antonazzo Emanuel Raschi Chiara Ajolfi Manuela Baraghini Antonella Chiarello Antonella Chiarello Valentina Delmonte Lucio Di Castri Monia Donati Antonella Fadda Daniela Fedele Alessandra Ferretti Laura Gabrielli Silvia Gobbi Sereno Lughi Martina Mazzari Fabio Pieraccini Alessandro Renzetti Elsa Russi Chiara Scanelli Barbara Zanetti Elisabetta Poluzzi Elisabetta Poluzzi Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region Frontiers in Pharmacology drug-drug interactions (DDIs) older peolpe drug utilization inappropriateness nursing home community dwelling |
| title | Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region |
| title_full | Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region |
| title_fullStr | Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region |
| title_full_unstemmed | Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region |
| title_short | Comparing the Prevalence of Polypharmacy and Potential Drug-Drug Interactions in Nursing Homes and in the Community Dwelling Elderly of Emilia Romagna Region |
| title_sort | comparing the prevalence of polypharmacy and potential drug drug interactions in nursing homes and in the community dwelling elderly of emilia romagna region |
| topic | drug-drug interactions (DDIs) older peolpe drug utilization inappropriateness nursing home community dwelling |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2020.624888/full |
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