Drug-drug interactions in the elderly.
OBJECTIVE
To detect the frequency of potential drug-drug interactions (DDIs) in an outpatient group of elderly people in 6 European countries, as well as to describe differences among countries.


METHODS
Drug use data were collected from 1601 elderly persons living in 6 European countries. The study population participated in a controlled intervention study over 18 months investigating the impact of pharmaceutical care. Potential DDIs were studied using a computerized detection program.


RESULTS
The elderly population used on average 7.0 drugs per person; 46% had at least 1 drug combination possibly leading to a DDI. On average, there were 0.83 potential DDIs per person. Almost 10% of the potential DDIs were classified to be avoided according to the Swedish interaction classification system, but nearly one-third of them were to be avoided only for predisposed patients. The risk of subtherapeutic effect as a result of a potential DDI was as common as the risk of adverse reactions. Furthermore, we found differences in the frequency and type of potential DDIs among the countries.


CONCLUSIONS
Potential DDIs are common in elderly people using many drugs and are part of a normal drug regimen. Some combinations are likely to have negative effects; more attention must be focused on detecting and monitoring patients using such combinations. As differences in potential DDIs among countries were found, the reasons for this variability need to be explored in further studies.
Björkman
Ingeborg K
IK
Apoteket AB (Swedish National Corporation of Pharmacies), Stockholm, Sweden. ingeborg.bjorkman@sos.se
Fastbom
Johan
J
Schmidt
Ingrid K
IK
Bernsten
Cecilia B
CB
D000368:Aged; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005060:Europe; D005260:Female; D005853:Geriatrics; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D004364:Pharmaceutical Preparations / Q000145:classification*; D015995:Prevalence
D004364:Pharmaceutical Preparations