Factores asociados a interacciones fármaco-fármaco potencialmente graves en pacientes adultos mayores en un hospital de Lima - Perú 2018 – 2019
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Advisors
Soto Tarazona, Alonso RicardoIssue Date
2020-11-19Keywords
Interacciones medicamentosasPolifarmacia
Factores de riesgo
Ancianos
Drug interaction
Polypharmacy
Risk factors
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Factors associated with potentially serious drug-drug interactions in elderly patients in a hospital in Lima - Peru 2018 – 2019Abstract
Antecedentes y Objetivo Los adultos mayores exhiben mayor probabilidad de presentar Interacciones droga-droga (DDI) potencialmente graves. El objetivo del estudio fue identificar la frecuencia de las interacciones farmacológicas potencialmente graves en adultos mayores atendida en un hospital de referencia peruano, así como sus factores asociados. Materiales y Métodos Estudio transversal analítico en pacientes atendidos en consultorio externo de geriatría en el Hospital Centro Médico Naval durante noviembre del 2018 - marzo 2019. Se registraron los datos consignados en las historias clínicas y se evaluó la presencia de DDIs utilizando la herramienta Lexicomp®️. Se evaluó la asociación con los potenciales factores utilizando un modelo de Regresión de Poisson con varianzas robustas. Resultados Se analizaron 306 historias clínicas. La mediana fue de edad de 74 (68-82) años con predominancia masculina (63,40%). El 27,78% de la población presentó interacciones farmacológicas potencialmente graves. El 61,76% recibía de 5 o más fármacos. El 97,06% presentó multimorbilidad y el 56,21% presentó hipertensión arterial. En el análisis bivariado, los factores significativamente asociados a las interacciones farmacológicas potencialmente graves fueron el género femenino (PR:0,65; IC:0,45-0,93; p=0,018), la osteoartritis (PR:1,82; IC:1,28-2,56; p=0,001), la presencia de síntomas depresivos (PR:1,80; IC:1,14-2,87; p=0,012) y la polifarmacia (PR:8,15; IC:3,66-18,11; p<0,001). En el análisis multivariado, los factores significativamente asociados a DDIs potencialmente graves fueron la polifarmacia (PR:8,05; IC:3,61-17,92; p<0,001) y la osteoartritis (PR:1,76; IC:1,29-2,40; p<0,001). Conclusiones La polifarmacia es el principal factor de riesgo para la presencia de DDIs graves. Se debe evaluar rutinariamente las posibles interacciones medicamentosas en pacientes geriátricos polimedicados.Background and Objectives Elderly are more likely to have potentially serious Drug-Drug Interactions (DDIs). The objective of the study was to identify the frequency of potentially serious drug interactions in the population of elderly treated at a Peruvian referral hospital, as well as their associated factors. Materials and Methods Analytical cross-sectional study in a population attended in the outpatient clinic of geriatrics at the Hospital Naval Medical Center during November 2018 - March 2019. The data recorded in the medical records were recorded and the presence of DDIs was evaluated using the Lexicomp®️ tool. The association with the potential factors was evaluated using a Poisson regression model with robust variances. Results We analyzed 306 clinical histories. The average age of 74 (68-82) years with male predominance (63,40%). 27,78% of the population had potentially serious drug interactions. Likewise, 61,76% consumed 5 to more drugs. 97,06% presented multimorbidity and 56,21% had arterial hypertension. In the bivariate analysis, the factors significantly associated with the potentially serious pharmacological interactions were the female gender (PR:0,65; CI:0,45-0,93; p=0,018), the presence of osteoarthritis (PR:1,82; CI:1,28-2,56; P=0,001), depressive symptoms (PR:1,80; CI:1,14-2,87; p=0,012), and polypharmacy (PR:8,15; CI:3,66-18,11; p<0,001). In the multivariate analysis, the factors significantly associated with potentially serious DDI were polypharmacy (PR:8,05; CI:3,61-17,92; P<0,001) and osteoarthritis (PR:1,76; CI:1,29-2,40; p<0,001). Conclusions Polypharmacy is the main risk factor for the presence of serious DDIs. Possible drug interactions should be routinely evaluated in polymedicated geriatric patients.
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info:eu-repo/semantics/openAccessAttribution-NonCommercial-ShareAlike 4.0 International
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