Aging
Navigate
Submit an Article
Research Paper|Volume 12, Issue 19|pp 19711—19739

Risk of hospitalization from drug-drug interactions in the Elderly: real-world evidence in a large administrative database

Floor Swart1, Giampaolo Bianchi2,3, Jacopo Lenzi4, Marica Iommi4, Lorenzo Maestri2, Emanuel Raschi2, Marco Zoli2,3, Fabrizio De Ponti2,3, Elisabetta Poluzzi2,3
  • 1School of Medicine, Vrije University of Amsterdam, Amsterdam, The Netherlands
  • 2Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  • 3Centre of Studies and Research on the Elderly, University of Bologna, Bologna, Italy
  • 4Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
Received: May 6, 2020Accepted: August 22, 2020Published: October 5, 2020
https://doi.org/10.18632/aging.104018

Copyright: © 2020 Swart et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The aim of this study was to assess the risk of hospitalization associated with the concomitant prescription of 10 highly prevalent drug-drug interactions (DDIs) among all individuals aged ≥65 residing in Bologna’s area, Italy. We used incidence density sampling, and the effect of current (last month) and past (≥30 days before) exposure to DDI was investigated through conditional multivariable logistic regression analysis.

Two DDIs were associated with increased hospitalization due to DDI related conditions: ACE-inhibitors/ diuretics plus glucocorticoids (current DDI: OR 2.36, 95% CI 1.94-2.87; past DDI: OR 1.36, 95% CI 1.12-1.65) and antidiabetic therapy plus current use of fluoroquinolones (OR 4.43, 95% CI 1.61-11.2). Non-Steroidal Anti-inflammatory Drugs (NSAIDs) increased the risk of re-bleeding in patients taking Selective Serotonin Reuptake Inhibitors (OR 5.56, 95% CI 1.24-24.9), while no significant effect was found in those without a history of bleeding episodes. Concomitant prescription of NSAIDs and ACE-inhibitors/diuretics in patients with a history of high-risk conditions was infrequent.

Within the pattern of drug prescriptions in the older population of Bologna’s area, we distinguished DDIs with actual clinical consequences from others that might be considered generally safe. Observed prescribing habits of clinicians reflect awareness of potential interactions in patients at risk.