Potential drug-drug interactions in elderly patients in a renal ward: a single-center retrospective study in Pakistan

Nouman Ahmad; Andika Yusuf Ramadhan; Asif Mahmood; Shah Faisal

doi:10.20884/1.api.2024.12.2.15510

Nouman Ahmad Master Program in Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia http://orcid.org/0009-0009-0699-0862
Andika Yusuf Ramadhan Clinical Pharmacology Specialist Study Program, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia http://orcid.org/0009-0008-9176-0879
Asif Mahmood Doctoral Program of Pharmaceutical Sciences, Department of Pharmacy, University of Malakand, Chakdara, Pakistan http://orcid.org/0009-0004-6165-3096
Shah Faisal Department of Pharmacy, Salim Habib University, NC-24, Deh Dih, Korangi Creek, Karachi, Pakistan http://orcid.org/0000-0002-7455-4108

DOI: https://doi.org/10.20884/1.api.2024.12.2.15510

Abstract

Background: The increasing prevalence of kidney disease among elderly populations has led to a rise in potential drug-drug interactions (pDDIs), particularly due to widespread polypharmacy use in this demographic.

Objective: This study aims to retrospectively analyze pDDIs and identify their prevalence and associated factors among elderly patients in a renal ward.

Methods: This retrospective observational study was conducted at Saidu Group of Teaching Hospital in Swat, Pakistan, from January to December 2022. Data were obtained from the Patients Records Office using a conventional paper-based record system. A sample of 43 elderly patients (age ≥60 years) was selected through consecutive sampling. Drug interactions were assessed using freely available online tools: Drugs.com and Medscape Drug Checker, selected for their user-friendly accessibility and suitability in resource-limited settings.

Results: Among the 43 elderly subjects with balanced gender distribution, the mean age was 66.53 ± 7.68 years. Comorbidities were present in 74.4% of patients, and each patient was prescribed an average of 4.58 medications. According to Medscape, 62.79% of patients experienced one or more potential drug interactions, while Drugs.com identified interactions in 67.44% of cases. Notably, 15% of these interactions were classified as high-risk by both tools. Logistic regression analysis indicated a significantly higher risk of potential drug interactions with increasing numbers of prescribed medications (OR = 4.515, p = 0.033).

Conclusion: This study identified a high prevalence of pDDIs among elderly patients with kidney disease in Pakistan. The majority had comorbidities necessitating multiple medications, thereby increasing the risk of adverse drug reactions (ADRs). Mitigating these risks requires accurate prescribing practices, reliable electronic surveillance systems, and clinical pharmacist support.

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