No primary clinical trial endpoint results are reported as this is a retrospective cross-sectional study assessing polypharmacy and potential drug-drug interactions in ICU patient prescriptions.
Cross-Sectional
Does polypharmacy increase the risk of potential drug-drug interactions in patients hospitalized in intensive care units?
Polypharmacy in the ICU significantly increases the risk of potential drug-drug interactions, with cardiovascular effects being the most common.
Objective: Drug-drug interactions (DDIs) can reduce treatment efficacy or cause toxicity. This study aimed to evaluate the frequency of polypharmacy and potential DDIs in intensive care units (ICUs). Material and Methods: Prescriptions from tertiary ICUs over a one-month period were retrospectively analyzed for polypharmacy and DDIs. Potential DDIs were identified using the Drugs.com interaction checker. Results: A mean of 8.1 drugs were prescribed per patient. DDI risk was detected in 77% of patients. Polypharmacy was observed in 88.7% of patients, with a significantly higher mean number of drugs in this group (8.9±2.8 vs. 4.1±2.2; p<0.001). The mean number of potential DDIs per patient was 3.7 times higher in the polypharmacy group (2.46±3.02 vs. 0.66±1.04; p<0.001), and the odds of at least one interaction were 10.8 times higher (OR: 10.83; 95% CI: 5.24-22.4). A strong positive correlation was found between the number of drugs and DDI risk (r=0.71; p<0.001). Moderate interactions were most common, while minor interactions were least frequent. The drugs most frequently involved in potential DDIs were furosemide, tramadol, phenytoin, dexamethasone, pantoprazole, and enoxaparin. The most common potential DDI was between pantoprazole and furosemide. Potential DDIs most frequently affected the cardiovascular system, followed by the central nervous, musculoskeletal, electrolyte balance, renal, and gastrointestinal systems. Clinical manifestations included QT prolongation, convulsions, muscle cramps, hypomagnesemia, and bleeding. Conclusion: Polypharmacy significantly increases the risk of DDIs. The use of DDI screening programs in ICUs with high rates of polypharmacy may improve clinical outcomes.
KUBAT et al. (Thu,) conducted a cross-sectional in Patients hospitalized in intensive care units. No primary clinical trial endpoint results are reported as this is a retrospective cross-sectional study assessing polypharmacy and potential drug-drug interactions in ICU patient prescriptions.