Ilana Levy1, Samuel Attias2,3, Eran Ben-Arye4,5, Lee Goldstein4,6, Elad Schiff1,2,4. 1. Internal Medicine B Department, Bnai Zion Medical Centre, Haifa, Israel. 2. Complementary Medicine Department, Bnai Zion Medical Centre, Haifa, Israel. 3. School of Public Health, University of Haifa, Haifa, Israel. 4. Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel. 5. Oncology Service, Lin Medical Centre, Clalit Health Services, Haifa and Western Galilee District, Israel. 6. Haemek Medical Centre, Afula, Israel.
Abstract
AIMS: Dietary and herbal supplements (DHS) are commonly used among inpatients and may cause interactions with drugs or other DHS. This study explored whether adverse events were actually associated with such interactions and examined specific characteristics among inpatient DHS users prone to such adverse events. METHODS: This was a cross-sectional study of 947 patients hospitalized in 12 departments of a tertiary academic medical centre in Haifa, Israel. It evaluated the rate of DHS use among inpatients, the potential for interactions, and actual adverse events during hospitalization associated with DHS use. It also assessed whether DHS consumption was documented in patients' medical files. Statistical analysis was used to delineate DHS users at risk for adverse events associated with interactions with conventional drugs or other DHS. RESULTS: In 17 (3.7%) of the 458 DHS users, an adverse event may have been caused by DHS-drug-DHS interactions. According to the Drug Interaction Probability Scale, 14 interactions 'probably' caused the adverse events, and 11 'possibly' caused them. Interactions occurred more frequently in older patients (P = 0.025, 95% CI: 2.26-19.7), patients born outside Israel (P = 0.025, 95% CI: 0.03-0.42), those with ophthalmologic (P = 0.032, 95% CI: 0.02-0.37) or gastrointestinal (P = 0.008, 95% CI: 0.05-0.46) comorbidities, and those using higher numbers of DHS (P < 0.0001, 95% CI: 0.52-2.48) or drugs (P = 0.027, 95% CI: 0.23-3.77). CONCLUSIONS: Approximately one in 55 hospitalizations in this study may have been caused by adverse events associated with DHS-drug-DHS interactions. To minimize the actual occurrence of adverse events, medical staff education regarding DHS should be improved.
AIMS: Dietary and herbal supplements (DHS) are commonly used among inpatients and may cause interactions with drugs or other DHS. This study explored whether adverse events were actually associated with such interactions and examined specific characteristics among inpatient DHS users prone to such adverse events. METHODS: This was a cross-sectional study of 947 patients hospitalized in 12 departments of a tertiary academic medical centre in Haifa, Israel. It evaluated the rate of DHS use among inpatients, the potential for interactions, and actual adverse events during hospitalization associated with DHS use. It also assessed whether DHS consumption was documented in patients' medical files. Statistical analysis was used to delineate DHS users at risk for adverse events associated with interactions with conventional drugs or other DHS. RESULTS: In 17 (3.7%) of the 458 DHS users, an adverse event may have been caused by DHS-drug-DHS interactions. According to the Drug Interaction Probability Scale, 14 interactions 'probably' caused the adverse events, and 11 'possibly' caused them. Interactions occurred more frequently in older patients (P = 0.025, 95% CI: 2.26-19.7), patients born outside Israel (P = 0.025, 95% CI: 0.03-0.42), those with ophthalmologic (P = 0.032, 95% CI: 0.02-0.37) or gastrointestinal (P = 0.008, 95% CI: 0.05-0.46) comorbidities, and those using higher numbers of DHS (P < 0.0001, 95% CI: 0.52-2.48) or drugs (P = 0.027, 95% CI: 0.23-3.77). CONCLUSIONS: Approximately one in 55 hospitalizations in this study may have been caused by adverse events associated with DHS-drug-DHS interactions. To minimize the actual occurrence of adverse events, medical staff education regarding DHS should be improved.
Authors: Nada A Helal; Heba A Eassa; Ahmed M Amer; Mohamed A Eltokhy; Ivan Edafiogho; Mohamed I Nounou Journal: Recent Pat Drug Deliv Formul Date: 2019
Authors: Ana Paula Nappi Arruda; Ana Patricia Ayala; Luciane C Lopes; Cristiane C Bergamaschi; Caio Guimarães; Mariana Del Grossi; Leonardo A R Righesso; Arnav Agarwal; Regina El Dib Journal: BMJ Open Date: 2017-07-26 Impact factor: 2.692
Authors: Ana Paula Nappi Arruda; Yuchen Zhang; Huda Gomaa; Cristiane de Cássia Bergamaschi; Caio Chaves Guimaraes; Leonardo A R Righesso; Mariana Del Grossi Paglia; Silvio Barberato-Filho; Luciane Cruz Lopes; Ana Patricia Ayala Melendez; Luciane Dias de Oliveira; Lucas Paula-Ramos; Bradley Johnston; Regina El Dib Journal: BMJ Open Date: 2019-05-24 Impact factor: 2.692