ICOPMAP SPECIAL EDITION Drug interactions in geriatric patients with cardiovascular diseases in Indonesia: A cross-sectional study using the Medscape Drug Interaction Checker
DOI:
https://doi.org/10.46542/pe.2025.252.2226Keywords:
Cardiovascular disease, Drug interaction, Geriatric patient, Medscape drug interaction checker, PolypharmacyAbstract
Background: Polypharmacy in geriatric patients with cardiovascular diseases poses significant clinical challenges in Indonesian healthcare settings.
Objective: To analyse drug interactions in geriatric patients with cardiovascular diseases using the Medscape Drug Interaction Checker at a tertiary care hospital in Indonesia.
Methods: A cross-sectional study was conducted among 80 geriatric patients with cardiovascular diseases at Ulin Banjarmasin Hospital. Drug interactions were analysed using the Medscape Drug Interaction Checker, with multivariable logistic regression and propensity score matching employed for confounding control.
Results: A significant positive correlation was observed between the number of prescribed medications and drug interactions (Spearman's rho = 0.225, p < 0.05). Of the identified interactions, 73.33% required close monitoring, 13.33% were severe, and 13.33% were minor. Predominantly observed. Patients aged ≥ 80 years had a higher risk of drug interactions compared to those aged 60-69 years (OR: 1.8, 95% CI: 1.3-2.5).
Conclusion: Drug interactions are highly prevalent among Indonesian geriatric cardiovascular patients, particularly in those with multiple medications and advanced age.
References
Calderón-Larrañaga, A., Poblador-Plou, B., González-Rubio, F., Gimeno-Feliu, L. A., Abad-Díez, J. M., & Prados-Torres, A. (2012). Multimorbidity, polypharmacy, referrals, and adverse drug events: Are we doing things well? British Journal of General Practice, 62(605), e821‒e826. https://doi.org/10.3399/bjgp12X659295
Fried, T. R., O'Leary, J., Towle, V., Goldstein, M. K., Trentalange, M., & Martin, D. K. (2014). Health outcomes associated with polypharmacy in community‐dwelling older adults: A systematic review. Journal of the American Geriatrics Society, 62(12), 2261‒2272. https://doi.org/10.1111/jgs.13153
Holm, J., Eiermann, B., Kimland, E., & Mannheimer, B. (2019). Prevalence of potential drug-drug interactions in Swedish pediatric outpatients. PLoS ONE, 14(8), e0220685. https://doi.org/10.1371/journal.pone.0220685
Jazbar, J., Locatelli, I., Horvat, N., & Kos, M. (2018). Clinically relevant potential drug-drug interactions among outpatients: A nationwide database study. Research in Social and Administrative Pharmacy, 14(6), 572‒580. https://doi.org/10.1016/j.sapharm.2017.07.004
Jiang, H., Lin, Y., Ren, W., Fang, Z., Liu, Y., Tan, X., Lv, X., & Zhang, N. (2022). Adverse drug reactions and correlations with drug‒drug interactions: A retrospective study of reports from 2011 to 2020. Frontiers in Pharmacology, 13, 923939. https://doi.org/10.3389/fphar.2022.923939
Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC Geriatrics, 17(1), 230. https://doi.org/10.1186/s12877-017-0621-2
Page, A. T., Clifford, R. M., Potter, K., Schwartz, D., & Etherton‐Beer, C. D. (2016). The feasibility and effect of deprescribing in older adults on mortality and health: A systematic review and meta‐analysis. British Journal of Clinical Pharmacology, 82(3), 583‒623. https://doi.org/10.1111/bcp.12975
Tian, F., Chen, Z., Zeng, Y., Feng, Q., & Chen, X. (2023). Prevalence of use of potentially inappropriate medications among older adults worldwide: A systematic review and meta-analysis. JAMA Network Open, 6(8), e2326910. https://doi.org/10.1001/jamanetworkopen.2023.26910vv
Thompson, W., Reeve, E., Moriarty, F., Maclure, M., Turner, J., Steinman, M. A., Conklin, J., Dolovich, L., McCarthy, L., & Farrell, B. (2019). Deprescribing: Future directions for research. Research in Social and Administrative Pharmacy, 15(6), 801‒805. https://doi.org/10.1016/j.sapharm.2018.08.013
Wastesson, J. W., Morin, L., Tan, E. C. K., & Johnell, K. (2018). An update on the clinical consequences of polypharmacy in older adults: A narrative review. Expert Opinion on Drug Safety, 17(12), 1185‒1196. https://doi.org/10.1080/14740338.2018.1546841