Polypharmacy Induced Drug Interactions, Adverse Drug Reactions (ADR) And Medication Errors In Tertiary Care South Indian Hospital

ABSTRACT

Objective: To study the pattern of drug interactions (DI) in our hospital and to identify whether it is associated with polypharmacy. To determine the level of severity of potential drug-drug interactions (PDDI), to detect, monitor and prevention of ADRs in the hospitalized patients and to identify the medication errors (ME). Methods: A prospective interventional study was conducted in a 300 bedded tertiary care South Indian hospital for a period of 6 mo. Prescriptions were analysed for PDDI using Micromedex software 2.2. The causality and severity of ADRs were assessed by using Naranjo’s, WHO UMC Scales and Hart wigs severity scales. ME was identified by review of patient drug charts. Results: Total 190 prescriptions were analyzed, in which 1028 drug interactions were seen. Out of which 718 were DDI, 198 DFI, 100 DEI, and 12 DTI were observed. More number of DI was seen in cardiovascular drugs, antibiotics followed by antacids and antiulcer agents. A total of 52 ADRs were identified in 43 patients. Diuretics, cardiovascular drugs were associated with a higher incidence of ADRs followed by Anti-Diabetic agents. 58 ME was seen in 190 prescriptions, among them omission error, prescribing errors and Wrong dose error was seen. Conclusion: Clinical pharmacist plays a potential role in the health care system in assisting the physician i.e. modifying the number of drugs taken, number of doses taken, medication adherence, identification of drug interactions, preventing, monitoring and detection of ADRs and identifying the medication errors.