Potentially Inappropriate Medications Involved in Drug–Drug Interactions in a Polish Population over 80 Years Old: An Observational, Cross-Sectional Study

TL;DR

This study examines drug interactions and inappropriate medications in Polish seniors over 80, finding that automated analysis can improve treatment safety when combined with clinical judgment.

Contribution

The study provides up-to-date data on PIMs and DDIs in Polish elderly patients and highlights the importance of clinical verification in reducing inappropriate drug combinations.

Findings

DDIs were detected in 66.9% of the study group, while PIMs were detected in 94.4%.

Clinical verification reduced DDIs by over 1.5 times and interactions requiring therapy modification by nearly 3 times.

Painkillers, psychiatric, and neurological drugs were the most common PIMs involved in DDIs.

Abstract

The clinical context of drug interactions detected by automated analysis systems is particularly important in older patients with multimorbidities. We aimed to provide unique, up-to-date data on the prevalence of potentially inappropriate medications (PIMs) and drug–drug interactions (DDIs) in the Polish geriatric population over 80 years old and determine the frequency and the most common PIMs involved in DDIs. We analyzed all non-prescription and prescription drugs in a representative national group of 178 home-dwelling adults over 80 years old with excessive polypharmacy (≥10 drugs). The FORTA List was used to assess PIMs, and the Lexicomp® Drug Interactions database was used for DDIs. DDIs were detected in 66.9% of the study group, whereas PIMs were detected in 94.4%. Verification of clinical indications for the use of substances involved in DDIs resulted in a reduction in the total number of DDIs by more than 1.5 times, as well as in a nearly 3-fold decrease in the number of interactions requiring therapy modification and drug combinations that should be strictly avoided. The most common PIMs involved in DDIs were painkillers, and drugs used in psychiatry and neurology. Special attention should be paid to DDIs with PIMs since they could increase their inappropriate character. The use of automated interaction analysis systems, while maintaining appropriate clinical criticism, can increase both chances for a good therapeutic effect and the safety of the elderly during treatment processes.