Uncovering Hidden Drug Interactions: The Importance of Frequent Dose Adjustments

2023-09-27 19:31:24

The need for frequent drug dose adjustments in patients prescribed multiple medications might indicate the presence of drug interactions that were not previously known. This is what the results of a study published in the journal suggest PLOS Digital Health.

The study examined the electronic medical records of more than a million patients in Denmark and identified nearly 4,000 drug combinations associated with more frequent dosage adjustments when co-administered. Of these combinations, 83% were associated with known drug interactions. The authors suggest that the remaining 694 drug pairs may be involved in previously unidentified drug interactions.

Søren Brunak, professor at the University of Copenhagen and research director of the Novo Nordisk Foundation Protein Research Center, told Univadis.com that their method can be used to identify new drug interactions.

Polypharmacy is particularly common among older adults who are more likely to have multiple chronic conditions. It is associated with increased health risks due to the possibility of harmful drug interactions. Research on polypharmacy has typically focused on the number and type of medications a patient receives. Søren Brunak and his team wanted to find out how the dosage of each drug might also impact interactions and health outcomes.

Their approach was to use a large real-world data set as a starting point to identify a wide range of potential interactions that might not be identified in smaller clinical trials. According to Søren Brunak, follow-up studies might be carried out on the pairs identified in their research to determine whether there is indeed an interaction and whether certain side effects are more likely.

Interactions between drugs are not necessarily contraindications to their joint use, explained Pierre Marquet, president of the European Association for Clinical Pharmacology and Therapeutics in an interview with Univadis .com. Patients who take multiple medications often have serious illnesses. For some, the benefits of taking medications with known interactions may outweigh the associated side effects, which doctors can help manage.

Pierre Marquet, who was not involved in the study, added that dose adjustments do not necessarily explain all adverse drug reactions and, conversely, adjustments may be made for a variety of reasons.

“The problem with polypharmacy is not just the number of medications or their drug interactions. It is also regarding the suitability of the medicine, taking into account the pathology and situation of the patient,” he said. As an example, Pierre Marquet cited patients whose life expectancy is limited and who often continue to take preventative medications long-term.

He suggested that in the future, more research should be done on interactions with anti-infective drugs, an area that has been neglected in the literature. Pierre Marquet further stated that it would be important to take into consideration combinations comprising more than two drugs. Although these patient groups are necessarily smaller, applying a similar research technique to large data sets allows for improved statistical power.

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