Drug-drug interactions and polypharmacy in patients with cognitive impairment
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.213793Keywords:
Dementia, Cognitive impairment, Drug interactions, PolypharmacyAbstract
Introduction: Patients with dementia are prone to taking multiple medications, contributing to increased drug-drug interactions. This study aimed to evaluate the frequency of polypharmacy cases in patients with dementia and to determine whether the use of the digital calculator is useful for identifying potential drug interactions. Methods: This is an observational retrospective study. Patients were divided by the presence or absence of polypharmacy. The polypharmacy group was split into patients with dementia and mild cognitive impairment (MCI). The drug interactions were analyzed using Lexicomp® (UpTo- Date) and stratified at the following levels: A (no interaction), B (without evidence of interaction), C (benefits potentially higher than risks), D (consider a change of therapy), and X (risks potentially higher than the benefits). Results: Of the 431 patients studied, 78.4% showed polypharmacy, with age significantly influencing this finding (P=0.0053). Alzheimer’s disease was the most prevalent. In the polypharmacy group, patients with MCI were younger than those with dementia (P=0.032). Type C interactions were the most prevalent, and there was no difference in pairing the types of interaction between the studied groups, despite the 1.5% type X interactions in the polypharmacy group, which had rivastigmine as the primary drug responsible for drug-drug interactions.
Conclusion: Polypharmacy occurs in four of five patients with dementia, and patients with Alzheimer’s disease have a significantly higher rate of polypharmacy than patients with mild cognitive impairment. Besides, polypharmacy did not influence the types of interaction between groups with and without polypharmacy. The use of the calculator helped to identify potential interactions between medications in this group of patients.
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Copyright (c) 2024 Maruan Charkieh, Murilo Gadens, Urbano Martins Terceiro , Ricardo Martinez, Nelson Dal Santos, Renato Mitsunori Nisihara
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