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Potentially severe drug – drug interactions among older people and associations in assisted living facilities in Finland: a cross-sectional study

View Article: PubMed Central - PubMed

ABSTRACT

Objective: This study aims to assess potentially severe class D drug–drug interactions (DDDIs) in residents 65 years or older in assisted living facilities with the use of a Swedish and Finnish drug–drug interaction database (SFINX).

Design: A cross-sectional study of residents in assisted living facilities in Helsinki, Finland.

Setting: A total of 1327 residents were assessed in this study. Drugs were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and DDDIs were coded according to the SFINX.

Main outcome measures: Prevalence of DDDIs, associated factors and 3-year mortality among residents.

Results: Of the participants (mean age was 82.7 years, 78.3% were females), 5.9% (N = 78) are at risk for DDDIs, with a total of 86 interactions. Participants with DDDIs had been prescribed a higher number of drugs (10.8 (SD 3.8) vs. 7.9 (SD 3.7), p < 0.001). A larger proportion of residents with DDDIs suffered from rheumatoid arthritis or osteoarthritis than those not exposed to DDDIs (24.7% vs. 15.4%, p = 0.030). The most frequent DDDIs were related to the concomitant use of potassium with amiloride (N = 12) or spironolactone (N = 12). Carbamazepine (N = 13) and methotrexate (N = 9) treatments were also frequently linked to DDDIs. During the follow-up, no differences in mortality emerged between the participants exposed to DDDIs and the participants not exposed to DDDIs.

Conclusions: Of the residents in assisted living, 5.9% were exposed to DDDIs associated with the use of a higher number of drugs. Physicians should be trained to find safer alternatives to drugs associated with DDDIs.

Key points: Potentially severe, class D drug–drug interactions (DDDIs) have been defined in the SFINX database as clinically relevant drug interactions that should be avoided.

Key points:  • Of the residents in assisted living, 5.9% were exposed to DDDIs that were associated with the use of a higher number of drugs.

Key points:  • The most frequent DDDIs were related to the concomitant use of potassium with amiloride or spironolactone. Carbamazepine and methotrexate were also linked to DDDIs.

Key points:  • No difference in mortality was observed between residents exposed to DDDIs and residents not exposed to DDDIs.

Key points:  • No difference in mortality was observed between residents exposed to DDDIs and residents not exposed to DDDIs.

No MeSH data available.


Flow chart of the study.
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Figure 0001: Flow chart of the study.

Mentions: A cross-sectional study was carried out among older people in all residential care facilities in the cities of Helsinki and Espoo, Finland, based on data collected in February 2007 as part of a larger project investigating nutritional status and nutritional care.[19] The study includes all 36 and 33 residential care units located in Helsinki and Espoo, respectively. Of the eligible residents (N = 2188), 67% (N = 1475) consented to participate in the study. Nonparticipants either refused (28%, N = 608) or were residents in temporary respite care (5%, N = 105) (Figure 1). Of all residents, 148 were excluded due to complete medication or mortality data being unavailable. Data were thus available for a total of 1327 residents. The assisted living facilities in Helsinki and Espoo provide round-the-clock care with a registered nurse in charge, similar to traditional nursing homes. However, the environment in assisted living units is more home-like than in traditional nursing homes. Resident characteristics are similar to those in traditional nursing homes.[19]


Potentially severe drug – drug interactions among older people and associations in assisted living facilities in Finland: a cross-sectional study
Flow chart of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036014&req=5

Figure 0001: Flow chart of the study.
Mentions: A cross-sectional study was carried out among older people in all residential care facilities in the cities of Helsinki and Espoo, Finland, based on data collected in February 2007 as part of a larger project investigating nutritional status and nutritional care.[19] The study includes all 36 and 33 residential care units located in Helsinki and Espoo, respectively. Of the eligible residents (N = 2188), 67% (N = 1475) consented to participate in the study. Nonparticipants either refused (28%, N = 608) or were residents in temporary respite care (5%, N = 105) (Figure 1). Of all residents, 148 were excluded due to complete medication or mortality data being unavailable. Data were thus available for a total of 1327 residents. The assisted living facilities in Helsinki and Espoo provide round-the-clock care with a registered nurse in charge, similar to traditional nursing homes. However, the environment in assisted living units is more home-like than in traditional nursing homes. Resident characteristics are similar to those in traditional nursing homes.[19]

View Article: PubMed Central - PubMed

ABSTRACT

Objective: This study aims to assess potentially severe class D drug–drug interactions (DDDIs) in residents 65 years or older in assisted living facilities with the use of a Swedish and Finnish drug–drug interaction database (SFINX).

Design: A cross-sectional study of residents in assisted living facilities in Helsinki, Finland.

Setting: A total of 1327 residents were assessed in this study. Drugs were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and DDDIs were coded according to the SFINX.

Main outcome measures: Prevalence of DDDIs, associated factors and 3-year mortality among residents.

Results: Of the participants (mean age was 82.7 years, 78.3% were females), 5.9% (N = 78) are at risk for DDDIs, with a total of 86 interactions. Participants with DDDIs had been prescribed a higher number of drugs (10.8 (SD 3.8) vs. 7.9 (SD 3.7), p < 0.001). A larger proportion of residents with DDDIs suffered from rheumatoid arthritis or osteoarthritis than those not exposed to DDDIs (24.7% vs. 15.4%, p = 0.030). The most frequent DDDIs were related to the concomitant use of potassium with amiloride (N = 12) or spironolactone (N = 12). Carbamazepine (N = 13) and methotrexate (N = 9) treatments were also frequently linked to DDDIs. During the follow-up, no differences in mortality emerged between the participants exposed to DDDIs and the participants not exposed to DDDIs.

Conclusions: Of the residents in assisted living, 5.9% were exposed to DDDIs associated with the use of a higher number of drugs. Physicians should be trained to find safer alternatives to drugs associated with DDDIs.

Key points: Potentially severe, class D drug–drug interactions (DDDIs) have been defined in the SFINX database as clinically relevant drug interactions that should be avoided.

Key points:  • Of the residents in assisted living, 5.9% were exposed to DDDIs that were associated with the use of a higher number of drugs.

Key points:  • The most frequent DDDIs were related to the concomitant use of potassium with amiloride or spironolactone. Carbamazepine and methotrexate were also linked to DDDIs.

Key points:  • No difference in mortality was observed between residents exposed to DDDIs and residents not exposed to DDDIs.

Key points:  • No difference in mortality was observed between residents exposed to DDDIs and residents not exposed to DDDIs.

No MeSH data available.