Drug Interactions in Iranian Veterans With Chronic Spinal Cord Injury - A Descriptive Study
International Clinical Neuroscience Journal,
Vol. 7 No. 4 (2020),
28 September 2020
,
Page 196-200
Abstract
Background: Veterans with chronic spinal cord injury usually have various comorbidities. They are, therefore, visited by different doctors and use different medications. It is necessary to monitor the health of these veterans. One of the important issues in this regard is the attention to drug interactions. The purpose of this study was to investigate the drugs used and their interactions.
Methods: This descriptive study of the cross-sectional studies was carried out retrospectively in 2015 under the Shefa Neuroscience Research Center’s supervision, examining the medical records of veterans with spinal cord injury participating in the health screening program at Khatam Alanbiya hospital in Tehran. Demographic data, comorbidities, used drugs, and the level of involvement collected. According to the FDA, drug interactions among the drugs used for each patient has evaluated and classified into three severe, moderate, and weak groups. SPSS v. 21 analyzed data.
Results: The study population consisted of 404 men, ranging in age from 41 to 74, with a mean of 51.6 ± 6.4 years. One hundred forty-two of them (35.1%) had a complete injury, and 262 veterans (64.8%) had an incomplete injury. Only 17 veterans (4.2%) had no drug interactions. The number of drug interactions varied from 1 to 38, with an average of 5.9 ± 12.8 interactions per patient. The total number of interactions was 2856, of which 32.5% were weak, 55.3% moderate, and 12.2% severe, with a 95% confidence interval. Among the severe drug interactions in the study, the highest number belonged to the antidepressant drugs.
Conclusion: This study highlights the necessity of developing a strategy for investigating and preventing drug interactions in veterans with chronic spinal cord injury. It has recommended that physicians pay more attention to other medications used by the patient and prescribe as little as possible of the drug and the drug with the least number of interactions.
- Veteran
- Spinal cord injury
- Drug
- Comorbidity
How to Cite
References
Ebrahimzadeh MH, Soltani-Moghaddas SH, Birjandinejad A, Omidi-Kashani F, Bozorgnia S. Quality of life among veterans with chronic spinal cord injury and related variables. Arch Trauma Res. 2014;3(2):e17917. doi: 10.5812/atr.17917.
Javadi M, Hafezi-Nejad N, Vaccaro AR, Rahimi-Movaghar V. Medical complications and patient outcomes in Iranian veterans with spinal cord injury. Adv Clin Exp Med. 2014;23(2):269-75. doi: 10.17219/acem/37075.
Azimi G, Divanbeigi A, Doroudi T, Emami A, Yarandi A. Health status of veterans with spinal cord injury during screening program in Tehran 2013: investigating the pulmonary function - a preliminary report. PeerJ Preprints; 2014. doi: 10.7287/ peerj.preprints.766v1.
Javadi Parvaneh M, Sahaf R, Delbari A, Kamrani AA, Fadaye Vatan R. Health status of elder spinal cord veterans. Iran J War Public Health. 2017;9(2):97-103. doi: 10.18869/acadpub. ijwph.9.2.97.
Magro L, Moretti U, Leone R. Epidemiology and characteristics of adverse drug reactions caused by drug-drug interactions. Expert Opin Drug Saf. 2012;11(1):83-94. doi: 10.1517/14740338.2012.631910.
Palleria C, Di Paolo A, Giofrè C, Caglioti C, Leuzzi G, Siniscalchi A, et al. Pharmacokinetic drug-drug interaction and their implication in clinical management. J Res Med Sci. 2013;18(7):601-10.
Karimian Z, Kheirandish M, Javidnikou N, Asghari G, Ahmadizar F, Dinarvand R. Medication errors associated with adverse drug reactions in Iran (2015-2017): A P-method approach. Int J Health Policy Manag. 2018;7(12):1090-6. doi: 10.15171/ijhpm.2018.91.
Wittich CM, Burkle CM, Lanier WL. Medication errors: an overview for clinicians. Mayo Clin Proc. 2014;89(8):1116-25. doi: 10.1016/j.mayocp.2014.05.007.
Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294(6):716-24. doi: 10.1001/ jama.294.6.716.
Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57- 65. doi: 10.1517/14740338.2013.827660.
Dumbreck S, Flynn A, Nairn M, Wilson M, Treweek S, Mercer SW, et al. Drug-disease and drug-drug interactions: systematic examination of recommendations in 12 UK national clinical guidelines. BMJ. 2015;350:h949. doi: 10.1136/bmj.h949.
12 Edersheim JG, Stern TA. Liability associated with prescribing medications. Prim Care Companion J Clin Psychiatry. 2009;11(3):115-9. doi: 10.4088/pcc.08r00717.
Harpaz R, Haerian K, Chase HS, Friedman C. Statistical mining of potential drug interaction adverse effects in FDA’s spontaneous reporting system. AMIA Annu Symp Proc. 2010;2010:281-5.
Saadat S, Javadi M, Sabet Divshali B, Tavakoli AH, Ghodsi SM, Montazeri A, et al. Health-related quality of life among individuals with long-standing spinal cord injury: a comparative study of veterans and non-veterans. BMC Public Health. 2010;10:6. doi: 10.1186/1471-2458-10-6.
Salamati P, Rostami R, Saadat S, Taheri T, Tajabadi M, Ranjbari G, et al. Comparison of health related quality of life between two groups of veteran and non-veteran spinal cord injured patients. Med J Islam Repub Iran. 2015;29:198.
Gharakhani M, Razeghi Jahromi S, Sadeghian H, Faghihzadeh S, Kazemi H, Arabkheradmand J, et al. Multiple drug interactions in war-injured veterans. Iran J War Public Health. 2010;2(4):23-8.
Bjerrum L, Andersen M, Petersen G, Kragstrup J. Exposure to potential drug interactions in primary health care. Scand J Prim Health Care. 2003;21(3):153-8. doi: 10.1080/02813430310001806.
Cruciol-Souza JM, Thomson JC. Prevalence of potential drug-drug interactions and its associated factors in a Brazilian teaching hospital. J Pharm Pharm Sci. 2006;9(3):427-33.
Hines LE, Murphy JE. Potentially harmful drug-drug interactions in the elderly: a review. Am J Geriatr Pharmacother. 2011;9(6):364-77. doi: 10.1016/j.amjopharm.2011.10.004.
Bethi Y, Shewade DG, Dutta TK, Gitanjali B. Prevalence and predictors of potential drug-drug interactions in patients of internal medicine wards of a tertiary care hospital in India. Eur J Hosp Pharm. 2018;25(6):317-21. doi: 10.1136/ ejhpharm-2017-001272.
Mousavi S, Ghanbari G. Potential drug-drug interactions among hospitalized patients in a developing country. Caspian J Intern Med. 2017;8(4):282-8. doi: 10.22088/cjim.8.4.282.
Sánchez-Fidalgo S, Guzmán-Ramos MI, Galván-Banqueri M, Bernabeu-Wittel M, Santos-Ramos B. Prevalence of drug interactions in elderly patients with multimorbidity in primary care. Int J Clin Pharm. 2017;39(2):343-53. doi: 10.1007/ s11096-017-0439-1.
Schneider KL, Kastenmüller K, Weckbecker K, Bleckwenn M, Böhme M, Stingl JC. Potential drug-drug interactions in a cohort of elderly, polymedicated primary care patients on antithrombotic treatment. Drugs Aging. 2018;35(6):559-68. doi: 10.1007/s40266-018-0550-6.
Coelho PV, Brum Cde A. Interactions between antidepressants and antihypertensive and glucose lowering drugs among patients in the HIPERDIA program, Coronel Fabriciano, Minas Gerais State, Brazil. Cad Saude Publica. 2009;25(10):2229- 36. doi: 10.1590/s0102-311x2009001000013.
Preskorn SH, Silkey B, Shah R, Neff M, Jones TL, Choi J, et al. Complexity of medication use in the Veterans Affairs healthcare system: Part I: Outpatient use in relation to age and number of prescribers. J Psychiatr Pract. 2005;11(1):5-15. doi: 10.1097/00131746-200501000-00002.
Puetz TW, Youngstedt SD, Herring MP. Effects of pharmacotherapy on combat-related PTSD, anxiety, and depression: a systematic review and meta-regression analysis. PLoS One. 2015;10(5):e0126529. doi: 10.1371/journal. pone.0126529.
Stella F, Loureiro JC, Pais MV, Canineu PR, Forlenza OV. Safety limits of antidepressant use plus combinations: focus on cardiovascular function. Curr Drug Metab. 2018;19(8):641- 52. doi: 10.2174/1389200219666171227203225.
Roughead EE, McDermott B, Gilbert AL. Antidepressants: prevalence of duplicate therapy and avoidable drug interactions in Australian veterans. Aust N Z J Psychiatry. 2007;41(4):366-70. doi: 10.1080/00048670701213294.
Sciarra T, Ciccotti M, Aiello P, Minosi P, Munzi D, Buccolieri C, et al. Polypharmacy and Nutraceuticals in veterans: pros and cons. Front Pharmacol. 2019;10:994. doi: 10.3389/ fphar.2019.00994.
- Abstract Viewed: 151 times
- PDF Downloaded: 223 times