Hospitalization and mortality among the elderly exposed to polytherapy and at risk of adverse drug reactions

Abstract

The increase in comorbidities due to an aging population determines a marked increase in the use of drugs (polypharmacy), which in turn carries a high risk of drug-drug interactions. This Paper will analyze the relationship between exposure to adverse drug interactions, and hospitalization and mortality in a cohort of elderly patients, living in a local Health Unit in Palermo, Italy. These patients were exposed to drugs whose concurrent use is contraindicated during the period 1.1.2014 - 30.12.2014. After a description of the most common drugs involved in adverse reactions, an evaluation of the extent of hospitalization and mortality will be performed. The results will demonstrate that there is an increasing risk of hospitalization and mortality as the degree of polypharmacy increases. Moreover, of the different classes of drug-drug interactions, those associated with the causation of QT prolongation present significantly higher risks for hospitalization and mortality, when compared to other classes of interactions. The implementation of appropriate tools, able to monitor drug prescriptions, could lower the number of hospitalizations and deaths, thus obviating the phenomenon of a prescriptions cascade.