Prevalence and determinants for potential drug-drug-interactions in the AGnES home visit population

T Fiß; N van den Berg; C Meinke; C Ritter; W Hoffmann

doi:10.1055/s-0030-1266284

Das Gesundheitswesen, Inhaltsverzeichnis

Prevalence and determinants for potential drug-drug-interactions in the AGnES home visit population

T Fiß ¹, N van den Berg ¹, C Meinke ¹, C Ritter ², W Hoffmann ¹

¹EMA-Universität Greifswald, Institut für Community Medicine, Greifswald
²EMA-Universität Greifswald, Institut für Pharmazie, Greifswald

Abstract

Introduction: 0.1 to 2.6% of all hospital admissions are due to drug-drug-interactions. There is an insufficient knowledge about prevalence and determinants of potential drug-drug-interactions (pDDI) in the ambulatory health care setting. In the AGnES-studies (GP-supporting, community-based, e-health-assisted, systemic intervention) GP-home visits were delegated to qualified AGnES-practice assistants. Here we analysed the prevalence and determinants of pDDI. Methods: Home-dwelling patients with limited mobility received IT-supported home medication review (HMR). Treatment diagnoses were extracted from patients' health record. The check for pDDI was conducted by using interaction monographs of the ABDA-database (ABDATA Pharmadatenservice, Eschborn). A binary logistic regression model was used to identify determinants for medium and serious pDDI (combined). Results: 779 patients (mean age f: 79.8yrs; m: 76.2yrs) received a complete HMR. Patients took a mean number of 7.8 active substances (SD=3.3) regularly. 626 patients (80.4%) had at least one pDDI (mean=4.8; SD=4.4), whereof 454 patients (58.3%) had only pDDI with medium or serious relevance (mean=2.9; SD=2.8). Most frequent medium pDDI was the combination of potassium excretion diuretics with anti-inflammatory drugs (n=258 patients). Adjusted for age and sex, multivariate binary logistic regression showed significant results for the number of taken active substances (continuous variable; OR=1.48; 95%-CI 1.382–1.585), metabolic diseases (OR=1.52; 95%-CI 1.039–2.223), musculo-skeletal diseases (OR=1.741; 95%-CI 1.204–2.517), infectious diseases (OR=0.127; 95%-CI 0.021–0.783), and gastro-intestinal diseases (OR=0.538; 95%-CI 0.322–0.899). Discussion: Drugs vary in their pDDI-inducing potential. Drugs for infectious diseases and gastro-intestinal diseases reduced chances to identify pDDI. The AGnES-population is characterized by a high proportion of pDDI with medium/serious relevance. Usually these pDDI require an intervention or intensified monitoring. The AGnES-population is not representative for the general population. Conclusion: We have presented an effective approach for the detection of pDDI in an ambulatory setting for a relevant patient group. Further investigations should focus on clinical outcome of pDDI.