An International Consensus List of Potentially Clinically Significant Drug-Drug Interactions in Older People
Anrys, P; Petit, A-E; Thevelin, S; Sallevelt, B; Drenth, C; Soiza, R L; Correa-Pérez, A; Dalleur, O; De Brauwer, I; Petrovic, M; Coleman, J J; Dalton, K; O'Mahony, D; Löwe, A; Thürig, S; Gudmundsson, A; Cherubini, A; Panos, A; Mavridis, D; Rodondi, N; Spinewine, Anne
(2021) Journal of the American Medical Directors Association, volume 22, issue 10, pp. 2121 - 2133.e24
(Article)
Abstract
OBJECTIVES: We aimed to establish an explicit list of potentially clinically significant drug-drug interactions (DDIs) in people aged ≥65 years. DESIGN: A preliminary list of potentially clinically significant DDIs was compiled, based on 154 DDIs identified from literature review. Subsequently, a 2-round online Delphi survey was undertaken with a multidisciplinary
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expert panel. A consensus meeting and a final round were conducted to validate the final DDI list and the scope of information provided. SETTING AND PARTICIPANTS: Twenty nine experts, including geriatricians and clinical pharmacists from 8 European countries. MEASURES: For each DDI, in the first 2 rounds, experts were asked to score the severity of potential harm on a 5-point Likert-type scale. DDIs were directly included on the final list if the median score was 4 (major) or 5 (catastrophic). DDIs with a median score of 3 (moderate) were discussed at a consensus meeting and included if ≥75% of participants voted for inclusion in the final round. RESULTS: Consensus was achieved on 66 potentially clinically significant DDIs (28 had a median score of 4/5 and 48 of 3 in the Delphi survey). Most concerned cardiovascular, antithrombotic, and central nervous system drugs. The final list includes information on the mechanism of interaction, harm, and management. Treatment modification is recommended for three-quarters of DDIs. CONCLUSION AND IMPLICATIONS: We validated a list of potentially clinically significant DDIs in older people, which can be used in clinical practice and education to support identification and management of DDIs or to assess prevalence in epidemiologic and intervention studies.
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Keywords: aged, Delphi technique, drug interactions, Geriatrics and Gerontology, Health Policy, General Nursing, Journal Article
ISSN: 1525-8610
Publisher: Elsevier Inc.
Note: Funding Information: Funding sources: This work is part of the project “OPERAM: OPtimising thERapy to prevent Avoidable hospital admissions in the Multi-morbid elderly” supported by the European Union's Horizon 2020 research and innovation program under the grant agreement no. 6342388, and by the Swiss State Secretariat for Education, Research, and Innovation (SERI) under contract number 15.0137. The opinions expressed and arguments employed herein are those of the authors and do not necessarily reflect the official views of the EC and the Swiss government. The work of Axel Löwe was partly funded by a grant from the Swiss National Science Foundation (SNSF 320030-172676 to Nicolas Rodondi). Funding Information: Funding sources: This work is part of the project “OPERAM: OPtimising thERapy to prevent Avoidable hospital admissions in the Multi-morbid elderly” supported by the European Union's Horizon 2020 research and innovation program under the grant agreement no. 6342388, and by the Swiss State Secretariat for Education, Research, and Innovation (SERI) under contract number 15.0137. The opinions expressed and arguments employed herein are those of the authors and do not necessarily reflect the official views of the EC and the Swiss government. The work of Axel Löwe was partly funded by a grant from the Swiss National Science Foundation (SNSF 320030-172676 to Nicolas Rodondi). Publisher Copyright: © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
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