Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct-Dec;8(4):180-186.
doi: 10.4103/picr.PICR_132_16.

A study of harmful drug-drug interactions due to polypharmacy in hospitalized patients in Goa Medical College

Akshay Khandeparkar  1 , Padmanabh V Rataboli  2
Affiliations

A study of harmful drug-drug interactions due to polypharmacy in hospitalized patients in Goa Medical College

Akshay Khandeparkar et al. Perspect Clin Res. 2017 Oct-Dec.

Abstract

Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy.

Materials and methods: A prospective, cross-sectional, observational study was performed from July 2011 to June 2012. Approval was obtained from the Institutional Ethics Committee, Goa Medical College. Drug interactions were identified using a computerized DDI database system Lexi-Comp version: 2.4.1. Quantitative data analysis was done by the SPSS for Windows version 17.0.

Results: Seven hundred and fifty-one out of 5424 (13.85%) prescriptions were observed to have polypharmacy with highest rates observed in the Department of Medicine. The median age of patients was 55.60 ± 13.86 (range 10-108 years). A total number of drugs per prescription ranged from minimum of 5 to maximum of 16 drugs, with an average of 7.96 ± 1.75. A large number of 596 prescriptions contained 6-9 drugs per prescription. Drugs involved in potential DDIs in our study included aspirin, antacids, beta-blockers, 3-hydroxy-3-methylglutaryl-coenzyme reductase inhibitors, calcium channel blockers, angiotensin-converting enzyme inhibitors, ondansetron, and H2 blockers.

Conclusion: Patients taking multiple medications experience unique pharmacotherapy. Personalized drug prescribing strategies and close monitoring of patients taking drugs with potential DDIs are keys to optimal therapeutic result.

Keywords: Adverse effect; drug–drug interactions; polypharmacy; super-polypharmacy.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Group of patients as per number of drug–drug interactions
Figure 2
Figure 2
Number of drug–drug interactions per prescription with polypharmacy
Figure 3
Figure 3
Department-wise breakup of drug–drug interactions
See this image and copyright information in PMC

References

    1. Bushardt RL, Massey EB, Simpson TW, Ariail JC, Simpson KN. Polypharmacy: Misleading, but manageable. Clin Interv Aging. 2008;3:383–9. - PMC - PubMed
    1. Alomar MJ. Factors affecting the development of adverse drug reactions (Review article) Saudi Pharm J. 2014;22:83–94. - PMC - PubMed
    1. Ruiz B, García M, Aguirre U, Aguirre C. Factors predicting hospital readmissions related to adverse drug reactions. Eur J Clin Pharmacol. 2008;64:715–22. - PubMed
    1. Gleason LJ, Luque AE, Shah K. Polypharmacy in the HIV-infected older adult population. Clin Interv Aging. 2013;8:749–63. - PMC - PubMed
    1. Kafeel H, Rukh R, Qamar H, Bawanty J, Jamshed M, Sheikh R, et al. Possibility of drug-drug interaction in prescription dispensed by community and hospital pharmacy. Pharmacology & Pharmacy. 2014;5:401–7.