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Assistant Clinical Specialist/Assistant Professor, Department of Experimental and Clinical Pharmacology and Institute for the Study of Geriatric Pharmacotherapy, College of Pharmacy, University of Minnesota, Minneapolis, MN; Clinical Pharmacist Specialist in Geriatrics, Minneapolis Veterans Affairs Medical Center, Minneapolis
Research Associate, Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota
Assistant Professor of Biometry, Department of Biostatistics and Bioinformatics and Center on Aging and Human Development, Duke University Medical Center, Durham, NC
Biostatistician, Center on Aging and Human Development, Duke University Medical Center
Assistant Professor of Clinical Pharmacy, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA
Assistant Research Professor, Division of Geriatric Medicine, Department of Medicine, Duke University Medical Center; Clinical Pharmacist Specialist in Geriatrics, Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham
Senior Fellow, Center on Aging and Human Development, Associate Professor, Division of Geriatric Medicine, Department of Medicine, Duke University Medical Center; Staff Physician, Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Durham
Professor, Division of Geriatric Medicine, Department of Medicine, School of Medicine, and Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh and Center for Health Equity Research and Promotion, Veterans Administration Pittsburgh Health Care System, Pittsburgh, PA
Reprints: Dr. Lindblad, Institute for the Study of Geriatric Pharmacotherapy, College of Pharmacy, 7-115 Weaver–Densford Hall, University of Minnesota, 308 Harvard St. SE, Minneapolis, MN 55455-0353, fax 612/625-3927, lindb047{at}umn.edu
BACKGROUND: Drugs can improve quality of life for many older people, but they may cause adverse health outcomes (eg, drug–disease interactions) if used inappropriately.
OBJECTIVE: To determine the prevalence of potential drug–disease interactions as defined by explicit criteria and examine associations between sociodemographic and health status variables and potential drug–disease interactions.
METHODS: The study design was cross-sectional. We evaluated 397 frail elderly inpatients from the Geriatric Evaluation and Management trial conducted at 11 Veterans Affairs Medical Centers. Drug–disease interactions were defined using explicit criteria from consensus expert panels of geriatricians from the US and Canada.
RESULTS: Overall, 159 (40.1%) patients had one or more potential
drug–disease interaction. The most common potential interactions were
calcium-channel blockers and heart failure (12.3%) and ß-blockers and
diabetes (6.8%). Multivariable logistic regression analyses revealed that age
75 years (adjusted OR 2.43; 95% CI 1.52 to 3.88), being married (adjusted
OR 1.77; 95% CI 1.11 to 2.82), comorbidity index defined by Charlson method
(adjusted OR 1.19; 95% CI 1.05 to 1.34), and use of multiple prescription
drugs (5–8: adjusted OR 4.17; 95% CI 1.96 to 8.88, 9: adjusted OR
9.22; 95% CI 4.26 to 19.95), were significantly (p < 0.05) associated with
having one or more potential drug–disease interaction.
CONCLUSIONS: Potential drug–disease interactions are common in hospitalized elderly patients and are related to specific sociodemographic and health status factors. Further research is needed to examine the relationship between health outcomes and drug–disease interactions.
Key Words: drug utilization, drug–disease interactions, elderly, epidemiology
Published Online, February 1, 2005. www.theannals.com, DOI 10.1345/aph.1E467
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