Medication Reconciliation and Drug–Drug Interactions: An Old Process with a New Approach
An old process with a new approach
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
review of recent literature. Integr Pharm Res Pract 2019;8:39-45.
2. Marinović I, Vrca VB, Samardžić I, Marušić S, Grgurević I. Potentially
inappropriate medications involved in drug–drug interactions at hospital
discharge in Croatia. Int J Clin Pharm. 2020. doi: 10.1007/s11096-020-
01164-4. In press.
3. Patel NS, Patel TK, Patel PB, Naik VN, Tripathi CB. Hospitalizations due to
preventable adverse reactions—a systematic review. Eur J Clin Pharmacol
4. Morimoto T, Gandhi TK, Seger AC, Hsieh TC, Bates DW. Adverse drug events
and medication errors: detection and classification methods. BMJ Qual Saf
5. McEvoy DS, Sittig DF, Hickman TT, et al. Variation in high-priority drug-drug
interaction alerts across institutions and electronic health records. J Am Med
Inform Assoc 2017;24(2):331-8.
6. Classen DC, Pestotnik SL, Evans RS, Burke JP. Computerized surveillance of
adverse drug events in hospital patients. JAMA 1991;266(20):2847-51.
7. Aronson J. Medication reconciliation. BMJ. 2017;356:i5336.
8. Aghajani MH, Ghazaeian M, Mehrazin HR, Sistanizad M, Miri M. Errors related
to medication reconciliation: A prospective study in patients admitted to the
post CCU. Iran J PharmSci.. 2016;15(2):599-604.
9. Berthe A, Fronteau C, Le Fur É, et al. Medication reconciliation: a tool to prevent
adverse drug events in geriatrics medicine. Geriatr Psychol Neuropsychiatr
10. Makiani MJ, Nasiripour S, Hosseini M, Mahbubi A. Drug-drug interactions:
The importance of medication reconciliation. J Res Pharm Pract
11. Reiner B, inventor. Medical reconciliation, communication, and educational
reporting tools. United States patent application US 13/403,529. 2012.
12. Tatro DS. Drug Interaction Facts 2013: The Authority on Drug Interactions.
Missouri: Wolters Kluwer Health; 2012.
13.Busa G, Burlina A, Damuzzo V, Chiumente M, Palozzo AC. Comorbidity,
polytherapy, and drug interactions in a neurological context: an example of
a multidisciplinary approach to promote the rational use of drugs. J Pharm
14. Karimzadeh I, Mirjalili M, Mirzaei E, Mottaghi S, Vazin A. Medication
reconciliation at admission by pharmacists in a teaching referral hospital in
Iran. Trends in Pharmaceutical Sciences 2019;5(1):65-72.
15. Zarif-Yeganeh M, Rastegarpanah M, Garmaroudi G, Hadjibabaie M, Vahedi
HSM. Incidence of medication discrepancies and its predicting factors in
emergency department.Iran J Public Health 2017;46(8):1086-94.
16. Atella V, Piano Mortari A, Kopinska J, et al. Trends in age-related disease
burden and healthcare utilization. Aging Cell 2019;18(1):e12861.
17. Juurlink DN, Mamdani M, Kopp A, Laupacis A, Redelmeier DA. Drug-drug
interactions among elderly patients hospitalized for drug toxicity. JAMA
2003;289(13):1652-8.44 jpc.tums.ac.ir March 2021;9(1)
Medication Reconciliation and Drug–Drug Interactions
18. Ahmad A, Khan MU, Haque I, et al. Evaluation of potential drug-drug
interactions in general medicine ward of teaching hospital in southern India.
J Clin Diagn Res 2015;9(2):FC10-3.
19. Alomar MJ. Factors affecting the development of adverse drug reactions. Saudi
Pharm J. 2014;22(2):83-94.
20.Gallagher P, Ryan C, Byrne S, Kennedy J, O Mahony D. STOPP (screening
tool of older person’s prescriptions) and START (screening tool to alert
doctors to right treatment). Consensus validation. Int J Clin Pharmacol Ther
21. World Health Organization. ICD-10 : international statistical classification of
diseases and related health problems: tenth revision. 2nd ed. Geneva: World
Health Organization; 2004.
|Issue||Vol 9 No 1 (2021): Winter 2021|
|Drug Interactions; Medication reconciliation; Drug Therapy; Patient Safety|
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