Interacciones farmacológicas potenciales en pacientes ambulatorios en expedientes de queja médica de la CONAMED

Abstract

Introduction: Drug interactions are a type of medication error that can cause harm to the patient. These must be detected during the validation of the prescription and corrected by the professional in charge of the patient care. The purpose of this study was the identification, classification and prevalence of drugs interactions, as well as the medications involved in outpatient consultations of patients with a medical complaint file from the National Medical Arbitration Commission (CONAMED). Material and methods: A descriptive, retrospective and cross-sectional observational study was carried out. The outpatient consultation prescriptions of the medical complaint files registered from 2013 to 2016 in the CONAMED pharmacotherapy system were reviewed. Results: 1,995 consultations were analyzed in 170 medical records. Only 1,720 met the inclusion criteria. The number of medications per consultation for the female sex was 5.1 ± 3.5 (p < 0.01). The average number of medications per consultation for patients = 65 years was 6.4 ± 3.8 (p < 0.01). The number of consultations with 5 or more medications (polypharmacy) in patients older than 65 or equal to 65 years was 305 (63.9%). The number of detected interactions according to severity were moderate 1415 (48.5%), higher 1,253 (43%), minor 193 (6.6%) and contraindicated 54 (1.9%), and according to their mechanism of action 46.8% correspond to pharmacodynamic interactions and 32.1% pharmacokinetics. The drugs most involved in the interactions are bezafibrate, pravastatin, captopril, metformin, acetylsalicylic acid, diclofenac, insulin and enalapril. Conclusion: Pharmacological interactions of a total of 8,282 medications prescribed in outpatient medical complaint records were analyzed. Pharmacological interactions occur more frequently in patients older than 65 years with polymedication and in the female gender. The majority are those that affect pharmacodynamics. The search for drug interactions with the use of softwares during the prescription should be carried out to improve treatment and patient safety. (English) [ABSTRACT FROM AUTHOR]