Zusammenfassung
ZIEL DER STUDIE: Unerwünschte Nebenwirkungen als Folge von Medikamenteninteraktionen spielen eine wichtige Rolle bei der Sicherheit von Medikamenten. Ziel dieser Studie war es, mögliche Medikamenteninteraktionen bei der Spitalsaufnahme und -entlassung zu erfassen, bzw. die Aufnahmen infolge solcher Interaktionen auf internen Abteilungen eines primären Stadtspitals und tertiären Referenzspitals zu evaluieren. METHODEN: Bei 520 zufällig ausgesuchten Patienten des medizinischen Zentrums der Universität Ljubljana wurden Alter, Geschlecht, Nieren- und Leberfunktion, Medikamente, Diagnosen sowie Dringlichkeit und Grund der Zuweisung retrospektiv erhoben. Bei den Patienten, bei denen Information über die bei Aufnahme und Entlassung eingenommenen Medikamente vorlag, wurde auf Medikamenteninteraktionen mittels des Interaktions-Screening Programms "Drug-Reax" geprüft. Basierend auf den erhobenen Daten wurde der Anteil an Aufnahmen, deren Grund eine Medikamenteninteraktion war, geschätzt. ERGEBNISSE: Bei 14,6% (76/520) Patienten war die Information über die Medikamentennamen bei Aufnahme nicht vollständig. Nach der Behandlung wurden 416 Patienten nach Hause entlassen, bei 52 von diesen (12,5%) war die Information über die Medikamentennamen im Entlassungsbrief ebenfalls unvollständig. Die restlichen 323 Patienten mit kompletter Information wurden in die Studie inkludiert. Mindestens eine Nebenwirkung wegen potentieller Medikamenteninteraktion hatten 51% (166/323) der Patienten bei Aufnahme und 63% (204/323) bei Entlassung (p = 0,001). Schwere potentiell interaktionsbedingte Nebenwirkungen hatten 13% (41/323) der Patienten bei Aufnahme und 18% (59/323) bei Entlassung (p = 0,001). Die gleichzeitige Gabe von ACE-Hemmern mit Spironolacton war die häufigste Interaktion. (20% der Interaktionen bei Aufnahme bzw. 25,6% bei Entlassung). Nur 2,4% (4/166) der Patienten mit potentiell interaktionsbedingter Nebenwirkungen wurden unter dieser Diagnose zugewiesen. 1,2% (2/323) aller Patienten wurden wegen Medikamenteninteraktion aufgenommen. SCHLUSSFOLGERUNGEN: Die Information über die Medikation der Patienten bei Spitals-Aufnahme und -entlassung ist nicht vollständig. Bei Aufnahme hatte die Hälfte und bei Entlassung zwei Drittel der Patienten potentiell interaktionsbedingte Nebenwirkungen. Unerwünschte durch Interaktionen von Medikamenten bedingte Nebenwirkungen machten 1,2% der Zuweisungen zur Aufnahme auf internen Abteilungen eines primären Stadtspitals und tertiären Referenzzentrums aus.
Summary
PURPOSE: Adverse drug reactions due to drug-drug interactions (DDIs) are important in drug safety. The aim of this study was to check potential DDIs (pDDIs) on hospital admission and discharge and to evaluate admissions due to DDIs in medical departments of a primary city and tertiary referral hospital. METHODS: Age, sex, presence of renal and liver failure, drug information, diagnosis, and urgency and reason for admission were retrospectively recorded in 520 randomly selected patients in medical departments of the University Medical Center Ljubljana. The screening program Drug-Reax was used to check for pDDIs in patients with drug information on both admission and discharge home, and the proportion of patients admitted as the consequence of a DDI was estimated. RESULTS: Overall, 14.6% (76/520) of patients had incomplete information on drug names in their medical documentation on admission; at the end of treatment 12.5% (52/416) of patients were discharged home with incomplete information on drug names in their discharge letters. A total of 323 patients had complete information on drug names on both admission and discharge and were included in the analysis of pDDIs: 51% (166/323) of patients on admission and 63% (204/323) on discharge had at least one pDDI (P = 0.001). Major pDDIs were found in 13% (41/323) of patients on admission and 18% (59/323) on discharge (P = 0.001). An ACE inhibitor combined with spironolactone was the most common major pDDI, representing 20.0% of all pDDIs on admission and 25.6% on discharge. Among patients with pDDI on admission, 2.4% (4/166) of were admitted because of an ADR caused by a DDI. Overall, 1.2% (4/323) of patients were admitted as the consequence of a DDI. CONCLUSIONS: The information on patient medication on hospital admission and discharge is incomplete. Half of patients on admission and almost two-thirds on discharge had pDDIs. ADRs due to DDIs caused 1.2% of admissions to medical departments in Ljubljana's primary city and tertiary referral hospital.
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Fokter, N., Možina, M. & Brvar, M. Potential drug-drug interactions and admissions due to drug-drug interactions in patients treated in medical departments. Wien Klin Wochenschr 122, 81–88 (2010). https://doi.org/10.1007/s00508-009-1251-2
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DOI: https://doi.org/10.1007/s00508-009-1251-2