Prevalence of drug-drug interactions in older people before and after hospital admission: analysis from the OPERAM trial

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dc.contributor.authorZerah, Lorèneen
dc.contributor.authorHenrard, Séverineen
dc.contributor.authorWilting, Ingeborgen
dc.contributor.authorO’Mahony, Denisen
dc.contributor.authorRodondi, Nicolasen
dc.contributor.authorDalleur, Oliviaen
dc.contributor.authorDalton, Kieranen
dc.contributor.authorKnol, Wilmaen
dc.contributor.authorHaschke, Manuelen
dc.contributor.authorSpinewine, Anneen
dc.date.accessioned2024-12-19T14:54:58Z
dc.date.available2024-12-19T14:54:58Z
dc.date.issued2021en
dc.description.abstractBackground: Drug-drug interactions (DDIs) are highly prevalent in older patients but little is known about prevalence of DDIs over time. Our main objective was to assess changes in the prevalence and characteristics of drug-drug interactions (DDIs) during a one-year period after hospital admission in older people, and associated risk factors. Methods: We conducted a sub-study of the European OPERAM trial (OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people), which assessed the effects of a structured medication review (experimental arm) compared to usual care (control arm) on reducing drug-related hospital readmissions. All OPERAM patients (≥70 years, with multimorbidity and polypharmacy, hospitalized in four centers in Bern, Brussels, Cork and Utrecht between December 2016 and October 2018, followed over 1 year) who were alive at hospital discharge and had full medication data during the index hospitalization (at baseline i.e., enrolment at admission, and at discharge) were included. DDIs were assessed using an international consensus list of potentially clinically significant DDIs in older people. The point-prevalence of DDIs was evaluated at baseline, discharge, and at 2, 6 and 12 months after hospitalization. Logistic regression models were performed to assess independent variables associated with changes in DDIs 2 months after baseline. Results: Of the 1950 patients (median age 79 years) included, 1045 (54%) had at least one potentially clinically significant DDI at baseline; point-prevalence rates were 58, 57, 56 and 57% at discharge, and 2, 6 and 12 months, respectively. The prevalence increased significantly from baseline to discharge (P <.001 [significant only in the control group]), then remained stable over time (P for trend.31). The five most common DDIs –all pharmacodynamic in nature– accounted for 80% of all DDIs and involved drugs that affect potassium concentrations, centrally-acting drugs and antithrombotics. At 2 months, DDIs had increased in 459 (27%) patients and decreased in 331 (19%). The main factor predictive of a change in the prevalence of DDIs was hyperpolypharmacy (≥10 medications). Conclusions: DDIs were very common; their prevalence increased during hospitalization and tended to remain stable thereafter. Medication review may help control this increase and minimize the risk of adverse drug events. © 2021, The Author(s).en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid571en
dc.identifier.citationZerah, L., Henrard, S., Wilting, I., O’Mahony, D., Rodondi, N., Dalleur, O., Dalton, K., Knol, W., Haschke, M. and Spinewine, A. (2021) 'Prevalence of drug-drug interactions in older people before and after hospital admission: analysis from the OPERAM trial', BMC Geriatrics, 21, 571 (11pp). https://doi.org/10.1186/s12877-021-02532-zen
dc.identifier.doihttps://doi.org/10.1186/s12877-021-02532-zen
dc.identifier.issued1
dc.identifier.journaltitleBMC Geriatricsen
dc.identifier.urihttps://hdl.handle.net/10468/16757
dc.identifier.volume21
dc.language.isoenen
dc.publisherBioMed Central Ltden
dc.rights© 2021, the Authors. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectDeprescribingen
dc.subjectDrug-drug interactionen
dc.subjectOlder personen
dc.subjectPolypharmacyen
dc.subjectPrevalenceen
dc.titlePrevalence of drug-drug interactions in older people before and after hospital admission: analysis from the OPERAM trialen
dc.typeArticle (peer-reviewed)en
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