Polypharmacy and Potential Drug–Drug Interactions in Home-Dwelling Older People – A Cross-Sectional Study
Received 15 December 2020
Accepted for publication 16 February 2021
Published 9 March 2021 Volume 2021:14 Pages 589—597
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Monica Hermann,1 Nina Carstens,2 Lars Kvinge,1 Astrid Fjell,1,3 Marianne Wennersberg,4 Kjersti Folleso,5 Knut Skaug,6 Ake Seiger,7 Berit Seiger Cronfalk,3,8 Anne-Marie Bostrom1,3,9
1Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Stord, Norway; 2Hospital Pharmacies Enterprise, Western Norway, Bergen, Norway; 3Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden; 4FOUSAM, Western Norway University of Applied Sciences, Haugesund, Norway; 5Bømlo Municipality, Hordaland, Norway; 6Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway; 7Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; 8Department of Health Care Sciences, Palliative Research Centre Ersta Sköndal Bräcke University College, Stockholm, Sweden; 9Theme Aging, Karolinska University Hospital, Huddinge, Sweden
Correspondence: Monica Hermann Tel + 47 53491477
Email [email protected]
Background: Risks associated with polypharmacy and drug–drug interactions represent a challenge in drug treatment, especially in older adults. The aim of the present study was to assess the use of prescription and non-prescription drugs and the frequency of potential drug–drug interactions in home-dwelling older individuals.
Methods: A cross-sectional study design was applied. Data were collected during preventive home visits among individuals aged ≥ 75 in three separate communities of Western Norway. A questionnaire, which was filled out by the individual, their next-of-kin, and the nurse performing the home visit was used for the collection of demographic and clinical data (age, sex, medication use, diagnoses, need of assistance with drug administration). Potential drug–drug interactions were identified electronically by IBM Micromedex Drug Interaction Checking. Point prevalence of potential drug–drug interactions and polypharmacy (≥ 5 drugs) were calculated. Binary logistic regression analyses were performed to assess factors potentially associated with polypharmacy or potential drug–drug interactions.
Results: Among the 233 individuals (mean age 78± 3 years, 46% male) included in the study, 43% used ≥ 5 drugs, 3.4% ≥ 10 drugs, while 4.3% used no drugs. In 54% of the 197 individuals using two or more drugs, at least one potential drug–drug interaction was detected. Low-dose aspirin and simvastatin were most frequently involved in potential drug–drug interactions. In total, 25% of the individuals reported current use of drugs sold over the counter of which more than 95% were analgesic drugs. Potential drug–drug interactions involving ibuprofen were identified in nine of 11 (82%) individuals using over-the-counter ibuprofen.
Conclusion: The study revealed a high prevalence of polypharmacy and potential drug–drug interactions with both prescription and non-prescription drugs in older home-dwelling individuals. Close monitoring of the patients at risk of drug–drug interactions, and increased awareness of the potential of over-the-counter drugs to cause drug–drug interactions, is needed.
Keywords: drug–drug interactions, polypharmacy, home-dwelling, old people
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