Prevalence and typology of potential drug interactions occurring in primary care patients.
OBJECTIVE
To investigate the prevalence and types of potential drug interactions in primary care patients to detect risky prescriptions as an essential condition to design intervention policies leading to an improvement in patient safety.


METHODS
Cross-sectional descriptive study.


METHODS
Two areas in Spain comprising 715,661 inhabitants.


METHODS
430,525 subjects with electronic medical records and assigned to a family doctor regularly updating them.


RESULTS
On a random day, 29.4% of the population was taking medication. Of these, 73.9% were at risk of suffering interactions, and these were found in 20.6% of them. The amount of interactions was higher among people with chronic conditions, the elderly, females and polymedicated patients. From the total of interactions, 55.1% belonged to the highest clinical relevance 'A' level, and 28.3% should have been avoided. The active ingredients primarily involved were hydrochlorothiazide and ibuprofen and, when focusing on those that should be avoided, omeprazole and acenocoumarol. The most frequent 'A' interaction that should be avoided was between non-conjugated excreted benzodiazepines and proton-pump inhibitors, followed by some NSAIDs and diuretics.


CONCLUSIONS
1 in 20 Spanish citizens is currently undergoing a potential drug interaction, including a high rate of clinically relevant ones that should be avoided. These results confirm the existence of a serious safety issue that should be approached and where all parties involved (physicians, health services, medical societies and patients) must do our bit to improve. Health services should foster the implementation of prescription alert systems linked with electronic medical records including clinical data.
Lopez-Picazo
Julio J
JJ
Gerencia de Atencion Primaria de Murcia, Murcia Health Service, Spain. julioj.lopez-picazo@carm.es
Ruiz
Juan C
JC
Sanchez
Jose F
JF
Ariza
Angeles
A
Aguilera
Belen
B
Lazaro
Dolores
D
Sanz
Gonzalo R
GR
D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain
D004364:Pharmaceutical Preparations