RESUMO
Objectives: Drug information systems are commonly used by professionals to assist in the identification of drug interactions and to ensure the safe use of medications. Real-world evidence about the comparison of different drug interaction sources is scarce. We aimed to compare two drug interaction databases to identify interactions in a population-based survey. Materials and Methods: This is a cross-sectional study based on a previous survey performed in the city of Manaus, Brazil, in 2019. We included adults aged 18 years and over, who used two or more medicines 15 days before the interview. To assess potential drug interactions, we searched Micromedex and UpToDate databases. The primary outcome was the prevalence of potential drug interactions in each database. Weighted Kappa statistics were calculated to assess agreement on the presence of drug interaction, documentation and severity. Results: A total of 752 participants were included in the study. The prevalence of drug interactions was 43.8% [95% confidence interval (CI): 40.2, 47.3%] in UpToDate and 30.2% (95% CI: 26.9, 33.5%), in Micromedex. The agreement related to drug interactions between the two databases was fair (Kappa: 0.631). For severity (Kappa: 0.398) and documentation (Kappa: 0.311), the agreement was poor. Conclusion: Agreement among compared databases was sub-optimal. Better quality and transparency of evidence available in drug interaction sources are needed to support informed healthcare professionals' decision.
RESUMO
OBJECTIVE: To assess the prevalence and factors associated with polypharmacy and the presence of potential drug interactions in Manaus, Amazonas state, Brazil, in 2019. METHODS: This was a population-based cross-sectional study conducted with adults aged ≥ 18 years. The presence of drug interactions among people on a polypharmacy regimen (≥ 5 drugs) was investigated on the Micromedex database. Prevalence ratios (PR) with 95% confidence intervals (95%CI) were calculated using Poisson regression model with robust variance, following hierarchical analysis and considering the complex sample design. RESULTS: Of the 2,321 participants, 2.8% (95%CI 2.1;3.6) were on polypharmacy regimen, of whom, 74.0% presented drug interactions, usually with four or more drug interactions per person (40.4%) and high severity (59.5%). Polypharmacy was higher among older adults (PR = 3.24; 95%CI 1.25;8.42), people with poor health (PR = 2.54; 95%CI 1.14;5.67), previous hospitalization (PR = 1.90; 95%CI 1.09;3.32) and multimorbidity (PR = 3.20; 95%CI 1.53;6.67). CONCLUSION: Polypharmacy was more frequent among older adults and people with medical problems, who presented more drug interactions.
Assuntos
Polimedicação , Idoso , Brasil/epidemiologia , Estudos Transversais , Interações Medicamentosas , Humanos , PrevalênciaRESUMO
Objective: To assess the prevalence and factors associated with polypharmacy and the presence of potential drug interactions among these individuals in Manaus, estado do Amazonas, Brazil, in 2019. Methods: Cross-sectional population-based study conducted with adults aged ≥18 years. Among people on polypharmacy (≥5 medicines), the presence of drug interactions was investigated in the icromedex database. Prevalence ratios (PR) were calculated by Poisson regression with robust variance, following hierarchical analysis and considering the complex sample design. Results: Out of the 2,321 participants were included, 2.8% (95%CI 2.1;3.6) were on polypharmacy, of which 74.0% presented drug interactions, with four or more interactions per person (40.4%) and high severity (59.5%) being the most frequent. Polypharmacy was higher among the elderly (PR=3.24 95%CI 1.25;8.42), poor health (PR=2.54 95%CI 1.14;5.67), previous hospitalization (PR=1.90 95%CI 1.09;3.32) and multimorbidity (PR=3.20 95%CI 1.53;6.67). Conclusion: Polypharmacy was more frequent among the elderly and people with health problems, who potentially had more drug interactions.
Objetivo: Analizar la prevalencia y factores asociados a polifarmacia y la presencia de posibles interacciones farmacológicas en Manaus, estado do Amazonas, Brasil, en 2019. Métodos: Estudio poblacional transversal realizado con adultos con edad ≥18 años. Entre personas en polifarmacia (≥5 medicamentos), se investigó la presencia de interacciones farmacológicas en Micromedex. Razones de prevalencia (RP) se calcularon mediante regresión de Poisson con varianza robusta, siguiendo análisis jerárquico y considerando el diseño de muestra complejo. Resultados: De los 2.321 participantes, 2,8% (IC95% 2,1;3,6) se encontraban en polifarmacia, de los cuales 74,0% presentaban interacciones, siendo más frecuentes cuatro o más interacciones por persona (40,4%) y de alta gravedad (59,5%). Polifarmacia fue mayor entre los ancianos (RP=3,24 IC95% 1,25;8,42), mala salud (RP=2,54 IC95% 1,14;5,67), hospitalización previa (RP=1,90 IC95% 1,09;3,32) y multimorbilidade (RP=3,20 IC95% 1,53;6,67). Conclusión: Polifarmacia fue más frecuente entre los ancianos y personas con problemas de salud, que potencialmente tenían más interacciones farmacológicas.
Objetivo: Analisar a prevalência e fatores associados à polifarmácia e a presença de potenciais interações medicamentosas em Manaus, estado do Amazonas, Brasil, em 2019. Métodos: Estudo transversal de base populacional, com adultos na idade ≥18 anos. Entre pessoas em polifarmácia (≥5 medicamentos), pesquisou-se a presença de interações medicamentosas na base Micromedex. Razões de prevalências (RP) foram calculadas por regressão de Poisson com variância robusta, seguindo análise hierárquica e considerando o delineamento amostral complexo. Resultados: Dos 2.321 participantes, 2,8% (IC95% 2,1;3,6) estavam em polifarmácia e destes, 74,0% apresentaram interações, sendo mais frequentes quatro ou mais interações por pessoa (40,4%) e gravidade alta (59,5%). Polifarmácia foi maior entre idosos (RP=3,24 IC95% 1,25;8,42), saúde ruim (RP=2,54 IC95% 1,14;5,67), hospitalização prévia (RP=1,90 IC95% 1,09;3,32) e multimorbidade (RP=3,20 IC95% 1,53;6,67). Conclusão: A polifarmácia foi mais frequente entre idosos e pessoas com problemas de saúde, que tiveram mais interações medicamentosas.
RESUMO
Objetivo: Analisar a prevalência e fatores associados à polifarmácia e a presença de potenciais interações medicamentosas em Manaus, estado do Amazonas, Brasil, em 2019. Métodos: Estudo transversal de base populacional, com adultos de ≥ 18 anos. Entre pessoas em polifarmácia (≥ 5 medicamentos), pesquisou-se a presença de interações medicamentosas na base Micromedex. Razões de prevalências (RP) com intervalos de confiança de 95% (IC95%) foram calculadas por regressão de Poisson com variância robusta, seguindo análise hierárquica e considerando o delineamento amostral complexo. Resultados: Dos 2.321 participantes, 2,8% (IC95% 2,1;3,6) estavam em polifarmácia e, destes, 74,0% apresentaram interações, sendo mais frequentes quatro ou mais interações por pessoa (40,4%) e gravidade alta (59,5%). Polifarmácia foi maior entre idosos (RP = 3,24; IC95% 1,25;8,42), pessoas com saúde ruim (RP = 2,54; IC95% 1,14;5,67), hospitalização prévia (RP = 1,90; IC95% 1,09;3,32) e multimorbidade (RP = 3,20; IC95% 1,53;6,67). Conclusão: A polifarmácia foi mais frequente entre idosos e pessoas com problemas de saúde, que tiveram mais interações medicamentosas.
Objetivo: Analizar la prevalencia y factores asociados a la polifarmacia y la presencia de posibles interacciones farmacológicas en Manaus, estado de Amazonas, Brasil, en 2019. Métodos: Estudio poblacional transversal realizado con adultos con edad ≥ 18 años. Entre personas en polifarmacia (≥ 5 medicamentos), se investigó la presencia de interacciones farmacológicas en Micromedex. Las razones de prevalencia (RP) con intervalos de confianza de 95% (IC95%) se calcularon mediante la regresión de Poisson con varianza robusta, siguiendo análisis jerárquico y considerando el diseño de muestra complejo. Resultados: De los 2.321 participantes, 2,8% (IC95% 2,1;3,6) se encontraban en polifarmacia, de los cuales 74,0% presentaban interacciones, siendo más frecuentes cuatro o más interacciones por persona (40,4%) y de alta gravedad (59,5%). La polifarmacia fue mayor entre los ancianos (RP = 3,24; IC95% 1,25;8,42), personas con mala salud (RP = 2,54; IC95% 1,14;5,67), hospitalización previa (RP = 1,90; IC95% 1,09;3,32) y multimorbilidade (RP = 3,20; IC95% 1,53;6,67). Conclusión: La polifarmacia fue más frecuente entre los ancianos y personas con problemas de salud, que potencialmente tenían más interacciones farmacológicas.
Objective: To assess the prevalence and factors associated with polypharmacy and the presence of potential drug interactions in Manaus, Amazonas state, Brazil, in 2019. Methods: This was a population-based cross-sectional study conducted with adults aged ≥ 18 years. The presence of drug interactions among people on a polypharmacy regimen (≥ 5 drugs) was investigated on the Micromedex database. Prevalence ratios (PR) with 95% confidence intervals (95%CI) were calculated using Poisson regression model with robust variance, following hierarchical analysis and considering the complex sample design. Results: Of the 2,321 participants, 2.8% (95%CI 2.1;3.6) were on polypharmacy regimen, of whom, 74.0% presented drug interactions, usually with four or more drug interactions per person (40.4%) and high severity (59.5%). Polypharmacy was higher among older adults (PR = 3.24; 95%CI 1.25;8.42), people with poor health (PR = 2.54; 95%CI 1.14;5.67), previous hospitalization (PR = 1.90; 95%CI 1.09;3.32) and multimorbidity (PR = 3.20; 95%CI 1.53;6.67). Conclusion: Polypharmacy was more frequent among older adults and people with medical problems, who presented more drug interactions.
Assuntos
Humanos , Farmacoepidemiologia/estatística & dados numéricos , Polimedicação , Interações Medicamentosas , Brasil/epidemiologia , Prevalência , Estudos Transversais , Uso de Medicamentos/estatística & dados numéricosRESUMO
Background: Drug interactions are important causes of adverse events. Assessments of pharmacological interactions outside healthcare services settings are scarce. Objective: To assess the frequency and factors associated with these potential interactions in adults living in Manaus, Amazonas, Brazil. Methods: We conducted a case-control study in 2019 with residents who had taken two or more medicines two weeks before the interview. The cases involved people with potential drug interaction, according to Micromedex™, and adults without drug interactions formed the control group. The factors associated with interaction were identified by multivariate logistic regression. Results: 752 adults out of 2321 interviewed were using two or more medicines and were included. The prevalence of potential drug interactions was 30.2% (95% CI: 26.9; 33.5%). We identified 457 drug interactions, more frequently one interaction per person (49.7%), of major severity (61.9%), and with fair documentation (61.7%); three individuals were using contraindicated associations. Individuals aged 45-59 years (OR 1.88, 95% CI 1.03-3.42), using 3 or more drugs simultaneously (p-value<0.001), had higher chance of drug interactions. Conclusion: Drug interaction was common in among adults living in Manaus, mostly of major severity. The odds of interaction increased with age and number of concomitantly medicines.
