Clinically relevant drug-drug interactions and the risk for drug adverse effects among home-dwelling older persons with and without type 2 diabetes

J Clin Pharm Ther. 2019 Oct;44(5):735-741. doi: 10.1111/jcpt.12854. Epub 2019 May 22.

Abstract

What is known and objective: Polypharmacy and age are known to increase the risk for potential drug interactions. Type 2 diabetes has been associated with polypharmacy and several comorbidities. Currently, there is no information on whether the frequency of clinically relevant drug-drug interactions and the risk for drug adverse effects differ between older persons with and without diabetes. The aim of this study was to investigate the frequency of drug-drug interactions and the risk for drug adverse effects in these two groups in primary care.

Methods: The basic study population consisted of Finnish home-dwelling primary care patients aged ≥ 65 years (N = 3039). For each person with diabetes, two controls were selected with adjusted age and gender. To collect data, electronic primary care patient records, a structured health questionnaire and a structured health examination conducted by a physician were utilized. Using the SFINX-PHARAO® database, drug-drug interactions and the risk for drug adverse effects were evaluated in 182 persons with type 2 diabetes and 176 persons without diabetes.

Results and discussion: There were no significant differences in the frequency of drug-drug interactions or the risk for drug adverse effects in persons with and without diabetes. At least one clinically relevant interaction was found in 81 (44.5%) persons with diabetes and 73 (41.5%) persons without diabetes. The most common drugs causing interactions included non-steroidal anti-inflammatory drugs (NSAIDs) and warfarin.

What is new and conclusion: There is no difference in the frequency of drug-drug interactions or risk for drug adverse effects in older home-dwelling persons with and without diabetes. Due to common comorbidities and commonly used drugs among persons with diabetes, drug-drug interactions involving warfarin or NSAIDs in particular should be carefully monitored to avoid drug adverse effects.

Keywords: adverse effect; diabetes; drug-drug interactions; elderly.

MeSH terms

  • Aged
  • Comorbidity
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Interactions / physiology*
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Female
  • Finland
  • Humans
  • Male
  • Polypharmacy
  • Practice Patterns, Physicians'
  • Primary Health Care / methods
  • Surveys and Questionnaires
  • Warfarin / adverse effects*
  • Warfarin / therapeutic use*

Substances

  • Warfarin