Muhammad Salman Rafi1, Syed Baqir Shyum Naqvi2, Muhammad Umair Khan3, Muhammad Fayyaz4, Nida Ashraf4, Maqsood Ahmed Khan4, Akram Ahmad3, Sameer Dhingra5. 1. Pharmacist, Department of Pharmacy Services, King Faisal Specialist Hospital and Research Center , Jeddah, Saudi Arabia . 2. Professor, Department of Pharmaceutics, Faculty of Pharmacy, Hamdard University , Karachi, Pakistan . 3. Lecturer, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University , Kuala Lumpur, Malaysia . 4. Student, Department of Pharmaceutics, Faculty of Pharmacy, University of Karachi , Karachi, Pakistan . 5. Lecturer, Department of Pharmacy Practice, School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, Champ Fleurs , Trinidad and Tobago .
Abstract
BACKGROUND: Limited resources of healthcare system and high use of antidepressants have raised some serious concerns regarding proper surveillance system of prescribed medicines. Not much literature is available from Pakistan regarding the potential drug-drug interactions (pDDIs) associated with antidepressants. OBJECTIVE: The objective of this study was to assess the frequency of pDDIs associated with antidepressants, their severity, significance and their association with patient characteristics. MATERIALS AND METHODS: A prospective, observational study was conducted in two major hospitals of Karachi for the period of three months. Patient profiles, medication charts, and physician notes were thoroughly reviewed to gather all the relevant information. Inclusion and exclusion criteria were set prior to data collection. The collected data was then analysed using Micromedex Drug-REAX System. Descriptive and binomial logistic regression analysis was used to express results. RESULTS: Of 245 prescriptions reviewed, 141 prescriptions had at least one pDDI (57.5%). A total of 181 pDDIs were identified in prescription containing antidepressant. The ratio of pDDI per prescriptions was 0.78. 42.5% interactions were moderate in severity, 30% of interactions were rapid in onset, and 43% were considered as significant interactions. Polypharmacy (OR=3.41, p< 0.001) and presence of chronic problems (OR=2.14, p=0.002) were significantly associated with the occurrence of pDDIs. Citalopram and diclofenac (11.6%) was commonly prescribed interacting pair in this study. CONCLUSION: The findings of this study recorded high frequency of antidepressants associated pDDIs. Our results confirm the significant association of polypharmacy with the occurrence of pDDIs with antidepressants. Future studies are warranted to establish these results by including hospitals in different parts of the country.
BACKGROUND: Limited resources of healthcare system and high use of antidepressants have raised some serious concerns regarding proper surveillance system of prescribed medicines. Not much literature is available from Pakistan regarding the potential drug-drug interactions (pDDIs) associated with antidepressants. OBJECTIVE: The objective of this study was to assess the frequency of pDDIs associated with antidepressants, their severity, significance and their association with patient characteristics. MATERIALS AND METHODS: A prospective, observational study was conducted in two major hospitals of Karachi for the period of three months. Patient profiles, medication charts, and physician notes were thoroughly reviewed to gather all the relevant information. Inclusion and exclusion criteria were set prior to data collection. The collected data was then analysed using Micromedex Drug-REAX System. Descriptive and binomial logistic regression analysis was used to express results. RESULTS: Of 245 prescriptions reviewed, 141 prescriptions had at least one pDDI (57.5%). A total of 181 pDDIs were identified in prescription containing antidepressant. The ratio of pDDI per prescriptions was 0.78. 42.5% interactions were moderate in severity, 30% of interactions were rapid in onset, and 43% were considered as significant interactions. Polypharmacy (OR=3.41, p< 0.001) and presence of chronic problems (OR=2.14, p=0.002) were significantly associated with the occurrence of pDDIs. Citalopram and diclofenac (11.6%) was commonly prescribed interacting pair in this study. CONCLUSION: The findings of this study recorded high frequency of antidepressants associated pDDIs. Our results confirm the significant association of polypharmacy with the occurrence of pDDIs with antidepressants. Future studies are warranted to establish these results by including hospitals in different parts of the country.
Entities:
Keywords:
Pakistan; Poly pharmacy; Surveillance system
Authors: Rachel P Riechelmann; Ian F Tannock; Lisa Wang; Everardo D Saad; Nathan A Taback; Monika K Krzyzanowska Journal: J Natl Cancer Inst Date: 2007-04-18 Impact factor: 13.506