Risk of Adverse Drug-Drug Interactions in Heart Failure Patients with Co-morbidity Chronic Kidney Disease Prescribed Polypharmacy

Abstract

Heart failure (HF) is a complex clinical syndrome due to the impairment of myocardial function, valvular or pericardial diseases, or anything interfering blood flow leading to fluid retention. A comorbidity that can accompany HF patients is chronic kidney disease (CKD). This condition requires consumption of several drugs simultaneously (polypharmacy). This study aimed to determine the risk of adverse drug-drug interactions in HF patients with co-morbid CKD prescribed polypharmacy. This is an analytic observational study with a cross-sectional approach in the Cardiac Outpatient Clinic of Ulin Public Hospital, Banjarmasin using medical records from 2020-2021. The interactions were determined using the UpToDate® under the Lexicomp tool. Prevalence Odds Ratio (POR) and 95% Confidence Intervals (95%CI) were determined using Logistic Regression analysis. Of 27 patients, 17 were males (62.96%). Most of the interactions (92.92%) were under category C and the moderate category (82 interactions, 82.83%). For HF patients with CKD, polypharmacy increased the risk of adverse drug-drug interactions by 2.75 times compared to those who were not prescribed polypharmacy, but it was not statistically significant (crude POR 2.75, 95% CI; 0.248-30.512). In conclusion, there is no significant relationship between polypharmacy and the risk of adverse drug-drug interactions in HF patients with CKD.

Keywords

• polypharmacy
• drug-drug interactions
• heart failure
• chronic kidney disease
• ulin public hospital
• banjarmasin