Potential Drug-Drug Interactions in Psychiatric Ward of a Tertiary Care Hospital: Prevalence, Levels and Association with Risk Factors
Purpose: To identify the prevalence of potential drug-drug interactions (pDDIs) in a psychiatric ward, their levels and association with risk factors.
Methods: This study was conducted in the psychiatric ward of Ayub Teaching Hospital, Abbottabad, Pakistan. Medical records of 415 patients were retrospectively reviewed for pDDIs using Micromedex Drug-Reax software. Logistic regression was applied to determine association of pDDIs with age, gender, hospital stay and number of drugs.
Results: In our study, we identified total number of 825 pDDIs of 126 types, with median number of 1 pDDIs per patient. Overall 64.8 % of the patients had at least one pDDI; 27.2 % at least one major pDDI; and 58.5 % patients at least one moderate pDDI. Among 825 identified pDDIs, most were of moderate (75.6 %) or major (20.8 %) severity, good (66.4 %) or fair (29 %) type of scientific evidence; and delayed onset (71 %). The most frequent major and moderate pDDIs included haloperidol + procyclidine (127 cases), haloperidol + olanzapine (49), haloperidol + promethazine (47), haloperidol + fluphenazine (41), diazepam + divalproex sodium (40), haloperidol + trihexyphenidyl (37), lorazepam + divalproex sodium (34), fluphenazine + procyclidine (33) and olanzapine + divalproex sodium (32). There was significant association of occurrence of pDDIs with hospital stay of 7 days or longer (p = 0.005) and taking 7 or more drugs (p < 0.001). Conclusion: A high prevalence of pDDIs in the psychiatric ward was recorded, a majority of which were of moderate severity. Patients with long hospital stay and increased number of drugs were more exposed to pDDIs.
Keywords: Drug-drug interactions, Potential drug-drug interaction, Prescriptions screening, Drug-related problems, Clinical pharmacy.
Submission of a manuscript to this journal is a representation that the manuscript has not been published previously and is not under consideration for publication elsewhere.
All authors named in each manuscript would be required to sign a form (to be supplied by the Editor) so that they may retain their copyright in the article but to assign to us (the Publishers) and its licensees in perpetuity, in all forms, formats and media (whether known or created in the future) to (i) publish, reproduce, distribute, display and store the contribution, (ii) translate the contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or abstracts of the contribution, (iii) create any other derivative works(s) based on the contribution, (iv) to exploit all subsidiary rights in the contribution, (v) the inclusion of electronic links from the contribution to third party material where-ever it may be located, and (vi) license any thrid party to do any or all of the above.