Medication Reconciliation and Drug–Drug Interactions: An Old Process with a New Approach

Shahram Ala; Sufia Tonkaboni; Aliyeh Bazi; Ebrahim Salehifar

doi:10.18502/jpc.v9i1.6035

Shahram Ala Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Sufia Tonkaboni Student Research Committee, Ramsar International Branch, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Aliyeh Bazi Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Ebrahim Salehifar Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.

DOI: https://doi.org/10.18502/jpc.v9i1.6035

Keywords: Drug Interactions; Medication reconciliation; Drug Therapy; Patient Safety

Abstract

Background: The occurrence of drug–drug interactions (DDIs) and insufficient attention to medication reconciliation is one of the important challenges of pharmacotherapy in hospitalized patients. The aim of this study was to determine the extent of drug–drug interactions in patients based on medication reconciliation strategy.

Methods: This descriptive cross-sectional study was performed for six months in patients admitted to Imam Reza Hospital in Amol, North of Iran. The data were obtained by using a medication reconciliation tool through a random sampling of patients admitted in Hospital wards from May 2014 until October 2014. A total of 200 patients were enrolled in the study. All patients had a history of medication use before admission. The drug interactions have been checked according to Drug Interaction Facts between newly prescribed drug and medication patient using before admission. The number and frequency of data were summarized by SPSS21 statistical software.

Results: Major and Moderate DDIs were found in 7.5% and 64% of prescriptions. The most frequent DDIs were seen in those who were taking psychiatric drugs (33%) and cardiovascular drugs (30%). Most DDIs occurred among women over 60 years of age. The most frequently occurring DDIs was pharmacokinetics interaction between clopidogrel and atorvastatin (n=9). Other frequent interactions were between ceftriaxone and heparin (n=8) and metoprolol and insulin (n=3).

Conclusion: This study showed a high rate of drug interactions and especially confirms the importance of medication reconciliation in providing a comprehensive drug history and exploring drug interactions.