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, Axel; Thürig, S.; Gudmundsson, A; Cherubini, A; Panos, A; Mavridis, D; Rodondi, Nicolas; ... (2021). An International Consensus List of Potentially Clinically Significant Drug-Drug Interactions in Older People. (In Press). Journal of the American Medical Directors Association Elsevier 10.1016/j.jamda.2021.03.019

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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 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Löwe, Axel Lennart; Thürig, Silvan Bernhard and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1538-9375

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

28 Apr 2021 20:33

Last Modified:

27 May 2021 22:21

Publisher DOI:

10.1016/j.jamda.2021.03.019

PubMed ID:

33901428

Uncontrolled Keywords:

Delphi technique aged drug interactions

BORIS DOI:

10.48350/156121

URI:

https://boris.unibe.ch/id/eprint/156121

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