PMID- 35996119 OWN - NLM STAT- MEDLINE DCOM- 20220824 LR - 20220909 IS - 1471-244X (Electronic) IS - 1471-244X (Linking) VI - 22 IP - 1 DP - 2022 Aug 22 TI - Clinical significance of potential drug-drug interactions in older adults with psychiatric disorders: a retrospective study. PG - 563 LID - 10.1186/s12888-022-04207-4 [doi] LID - 563 AB - BACKGROUND: Polypharmacy increases the risk of potential drug-drug interactions (pDDIs). This retrospective analysis was conducted to detect pDDIs and adverse drug reactions (ADRs) among older adults with psychiatric disorder, and identify pDDIs with clinical significance. METHODS: A retrospective analysis was carried out based on the medical records of older adults with psychiatric disorders. Data on demographic characteristics, substance abuse, medical history, and medications were extracted. The Lexi-Interact online database was used to detect pDDIs. The minimal clinically important difference (MCID) was set as the change in the Treatment Emergent Symptom Scale (TESS) score between admission and discharge. The median and interquartile ranges were used for continuous variables, and frequencies were calculated for dichotomous variables. Poisson regression was implemented to determine the factors influencing the number of ADR types. The influencing factors of each ADR and the clinical significance of the severity of the ADR were analysed using binary logistic regression. P < 0.05 was considered statistically significant. RESULTS: A total of 308 older adults were enrolled, 171 (55.52%) of whom had at least 1 pDDI. Thirty-six types of pDDIs that should be avoided were found, and the most frequent pDDI was the coadministration of lorazepam and olanzapine (55.5%). A total of 26 ADRs induced by pDDIs were identified, and the most common ADR was constipation (26.05%). There was a 9.4 and 10.3% increase in the number of ADR types for each extra medical diagnosis and for each extra drug, respectively. There was a 120% increase in the number of ADR types for older adults hospitalized for 18-28 days compared with those hospitalized for 3-17 days. There was an 11.1% decrease in the number of ADR types for each extra readmission. The length of hospitalization was a risk factor for abnormal liver function (P < 0.05). The use of a large number of drugs was a risk factor for gastric distress (P < 0.05) and dizziness and fainting (P < 0.05). None of the four pDDIs, including coadministrations of olanzapine and lorazepam, quetiapine and potassium chloride, quetiapine and escitalopram, and olanzapine and clonazepam, showed clinical significance of ADR severity (P > 0.05). CONCLUSIONS: pDDIs are prevalent in older adults, and the rate is increasing. However, many pDDIs may have no clinical significance in terms of ADR severity. Further research on assessing pDDIs, and possible measures to prevent serious ADRs induced by DDIs is needed to reduce the clinical significance of pDDIs. CI - (c) 2022. The Author(s). FAU - Liu, Yu AU - Liu Y AD - Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 211166. AD - Department of Nursing Management, Kangda College, Nanjing Medical University, Lianyungang, Jiangsu Province, P.R. China, 222000. FAU - Yang, Man AU - Yang M AD - Department of Psychiatry, The Fourth People's Hospital of Lianyungang, Affiliated to Kangda College, Nanjing Medical University, Lianyungang, Jiangsu Province, P.R. China, 222003. FAU - Ding, Yaping AU - Ding Y AD - Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 211166. FAU - Wang, Huanqiang AU - Wang H AD - Department of Occupational Medicine and Environmental Health, Kangda College, Nanjing Medical University, Lianyungang, Jiangsu Province, P.R. China, 222000. FAU - Zhang, Hailin AU - Zhang H AD - Department of Nursing, The First People's Hospital of Lianyungang, Affiliated to Kangda College, Nanjing Medical University, Lianyungang, Jiangsu Province, P.R. China, 222061. FAU - Wang, Dandan AU - Wang D AD - Department of Fundamental Nursing, Kangda College, Nanjing Medical University, Lianyungang, Jiangsu Province, P.R. China, 222000. FAU - Zhuang, Tianchi AU - Zhuang T AD - Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 211166. FAU - Ji, Minghui AU - Ji M AD - Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 211166. jiminghui@njmu.edu.cn. FAU - Cui, Yan AU - Cui Y AD - Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 211166. cyan_njmu@163.com. FAU - Wang, Hong AU - Wang H AD - Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China, 210029. hongwang@njmu.edu.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220822 PL - England TA - BMC Psychiatry JT - BMC psychiatry JID - 100968559 RN - 2S3PL1B6UJ (Quetiapine Fumarate) RN - N7U69T4SZR (Olanzapine) RN - O26FZP769L (Lorazepam) SB - IM MH - Aged MH - Drug Interactions MH - *Drug-Related Side Effects and Adverse Reactions/epidemiology MH - Humans MH - Lorazepam MH - *Mental Disorders/drug therapy MH - Olanzapine MH - Quetiapine Fumarate MH - Retrospective Studies PMC - PMC9394082 OTO - NOTNLM OT - Adverse drug reaction OT - Older adults OT - Potential drug-drug interaction OT - Psychiatric disorder COIS- The authors declare that they have no competing interests. EDAT- 2022/08/23 06:00 MHDA- 2022/08/25 06:00 PMCR- 2022/08/22 CRDT- 2022/08/22 23:37 PHST- 2022/01/25 00:00 [received] PHST- 2022/08/12 00:00 [accepted] PHST- 2022/08/22 23:37 [entrez] PHST- 2022/08/23 06:00 [pubmed] PHST- 2022/08/25 06:00 [medline] PHST- 2022/08/22 00:00 [pmc-release] AID - 10.1186/s12888-022-04207-4 [pii] AID - 4207 [pii] AID - 10.1186/s12888-022-04207-4 [doi] PST - epublish SO - BMC Psychiatry. 2022 Aug 22;22(1):563. doi: 10.1186/s12888-022-04207-4.