Potential drug interactions in adults and the older people in the hospital environment

Abstract

Objective: to determine the prevalence of potentially serious and contraindicated drug interactions in adult and older people patients in public, mixed and private hospital settings. Methods: cross-sectional study with prescriptions for 27,088 patients over 18 years of age, divided into the “Adults” and “Older people” groups, from six public hospitals and five mixed and private hospitals in three regions of Brazil in February 2023. Data were collected from NoHarm platform, a tool used to organize the clinical pharmacist’s work process, and analyzed potential serious and contraindicated drug interactions. Results: a total of 128,143 prescriptions were included in the study, 47.8% from the adults group and 52.2% from the older people group. The presence of at least one potential interaction in the prescription in the total population was 22.3%, being higher in the elderly population (24.5% vs. 19.9%, P < 0.001) in male patients (24.7% vs. 20.2%, P < 0.001), in prescriptions for patients in a 100% public hospital (27.8% vs. 16.1%, P < 0.001) and with a greater number of prescription items (18 vs. 3 items, P < 0.001). The total number of drug interactions found was 71,047, the most prevalent being among psychoactives and drugs that act on the gastrointestinal system, both in the adults group (32.9%) and in the older people group (22.4%). Conclusion: this study identified a high prevalence (22.3%) of drug interactions in hospitalized patients, more prevalent among older people and in public hospitals. The drug classes involved in the interactions varied between the adult and older people groups.