Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations
Abstract Background The co-administration of drugs known to interact greatly impacts morbidity, mortality, and health economics. This study aims to examine the drug–drug interaction (DDI) phenomenon with a large-scale longitudinal analysis of age and gender differences found in drug administration d...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-024-03384-1 |
| _version_ | 1797199419691499520 |
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| author | Jon Sánchez-Valle Rion Brattig Correia Marta Camacho-Artacho Rosalba Lepore Mauro M. Mattos Luis M. Rocha Alfonso Valencia |
| author_facet | Jon Sánchez-Valle Rion Brattig Correia Marta Camacho-Artacho Rosalba Lepore Mauro M. Mattos Luis M. Rocha Alfonso Valencia |
| author_sort | Jon Sánchez-Valle |
| collection | DOAJ |
| description | Abstract Background The co-administration of drugs known to interact greatly impacts morbidity, mortality, and health economics. This study aims to examine the drug–drug interaction (DDI) phenomenon with a large-scale longitudinal analysis of age and gender differences found in drug administration data from three distinct healthcare systems. Methods This study analyzes drug administrations from population-wide electronic health records in Blumenau (Brazil; 133 K individuals), Catalonia (Spain; 5.5 M individuals), and Indianapolis (USA; 264 K individuals). The stratified prevalences of DDI for multiple severity levels per patient gender and age at the time of administration are computed, and null models are used to estimate the expected impact of polypharmacy on DDI prevalence. Finally, to study actionable strategies to reduce DDI prevalence, alternative polypharmacy regimens using drugs with fewer known interactions are simulated. Results A large prevalence of co-administration of drugs known to interact is found in all populations, affecting 12.51%, 12.12%, and 10.06% of individuals in Blumenau, Indianapolis, and Catalonia, respectively. Despite very different healthcare systems and drug availability, the increasing prevalence of DDI as patients age is very similar across all three populations and is not explained solely by higher co-administration rates in the elderly. In general, the prevalence of DDI is significantly higher in women — with the exception of men over 50 years old in Indianapolis. Finally, we show that using proton pump inhibitor alternatives to omeprazole (the drug involved in more co-administrations in Catalonia and Blumenau), the proportion of patients that are administered known DDI can be reduced by up to 21% in both Blumenau and Catalonia and 2% in Indianapolis. Conclusions DDI administration has a high incidence in society, regardless of geographic, population, and healthcare management differences. Although DDI prevalence increases with age, our analysis points to a complex phenomenon that is much more prevalent than expected, suggesting comorbidities as key drivers of the increase. Furthermore, the gender differences observed in most age groups across populations are concerning in regard to gender equity in healthcare. Finally, our study exemplifies how electronic health records’ analysis can lead to actionable interventions that significantly reduce the administration of known DDI and its associated human and economic costs. |
| first_indexed | 2024-04-24T07:15:28Z |
| format | Article |
| id | doaj.art-b672f624fc494ef5b6cd4cf0e9d3e220 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-24T07:15:28Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-b672f624fc494ef5b6cd4cf0e9d3e2202024-04-21T11:21:21ZengBMCBMC Medicine1741-70152024-04-0122111710.1186/s12916-024-03384-1Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populationsJon Sánchez-Valle0Rion Brattig Correia1Marta Camacho-Artacho2Rosalba Lepore3Mauro M. Mattos4Luis M. Rocha5Alfonso Valencia6Life Sciences Department, Barcelona Supercomputing CenterInstituto Gulbenkian de CiênciaAgencia Española de Medicamentos y Productos SanitariosLife Sciences Department, Barcelona Supercomputing CenterUniversidade Regional de BlumenauInstituto Gulbenkian de CiênciaLife Sciences Department, Barcelona Supercomputing CenterAbstract Background The co-administration of drugs known to interact greatly impacts morbidity, mortality, and health economics. This study aims to examine the drug–drug interaction (DDI) phenomenon with a large-scale longitudinal analysis of age and gender differences found in drug administration data from three distinct healthcare systems. Methods This study analyzes drug administrations from population-wide electronic health records in Blumenau (Brazil; 133 K individuals), Catalonia (Spain; 5.5 M individuals), and Indianapolis (USA; 264 K individuals). The stratified prevalences of DDI for multiple severity levels per patient gender and age at the time of administration are computed, and null models are used to estimate the expected impact of polypharmacy on DDI prevalence. Finally, to study actionable strategies to reduce DDI prevalence, alternative polypharmacy regimens using drugs with fewer known interactions are simulated. Results A large prevalence of co-administration of drugs known to interact is found in all populations, affecting 12.51%, 12.12%, and 10.06% of individuals in Blumenau, Indianapolis, and Catalonia, respectively. Despite very different healthcare systems and drug availability, the increasing prevalence of DDI as patients age is very similar across all three populations and is not explained solely by higher co-administration rates in the elderly. In general, the prevalence of DDI is significantly higher in women — with the exception of men over 50 years old in Indianapolis. Finally, we show that using proton pump inhibitor alternatives to omeprazole (the drug involved in more co-administrations in Catalonia and Blumenau), the proportion of patients that are administered known DDI can be reduced by up to 21% in both Blumenau and Catalonia and 2% in Indianapolis. Conclusions DDI administration has a high incidence in society, regardless of geographic, population, and healthcare management differences. Although DDI prevalence increases with age, our analysis points to a complex phenomenon that is much more prevalent than expected, suggesting comorbidities as key drivers of the increase. Furthermore, the gender differences observed in most age groups across populations are concerning in regard to gender equity in healthcare. Finally, our study exemplifies how electronic health records’ analysis can lead to actionable interventions that significantly reduce the administration of known DDI and its associated human and economic costs.https://doi.org/10.1186/s12916-024-03384-1Drug–drug interactionsPolypharmacyMultimorbidityElectronic health records |
| spellingShingle | Jon Sánchez-Valle Rion Brattig Correia Marta Camacho-Artacho Rosalba Lepore Mauro M. Mattos Luis M. Rocha Alfonso Valencia Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations BMC Medicine Drug–drug interactions Polypharmacy Multimorbidity Electronic health records |
| title | Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations |
| title_full | Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations |
| title_fullStr | Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations |
| title_full_unstemmed | Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations |
| title_short | Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations |
| title_sort | prevalence and differences in the co administration of drugs known to interact an analysis of three distinct and large populations |
| topic | Drug–drug interactions Polypharmacy Multimorbidity Electronic health records |
| url | https://doi.org/10.1186/s12916-024-03384-1 |
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