Background
Methods
OPERAM trial
Eligibility criteria and follow-up
Drug-drug interactions: prevalence and characteristics
Changes in prevalence of DDIs
Statistical analysis
Results
Patient characteristics at baseline
Variables at baselinea | OR (95% CI) | P value |
---|---|---|
Age (reference: 70–79 years) - 80–89 years - > 90 years | 0.79 [0.64–0.97] 0.65 [0.44–0.96] | .02 .03 |
Sex (reference: female) - male | 0.81 [0.66–0.98] | .03 |
Medical history of depression | 2.88 [1.99–4.26] | < .001 |
Medical history of coronary artery disease | 1.25 [1.02–1.54] | .03 |
Medical history of heart failure | 1.60 [1.26–2.02] | < .001 |
Medical history of atrial fibrillation | 1.55 [1.26–1.90] | < .001 |
Medical history of chronic renal failure | 1.09 [0.87–1.36] | .46 |
Medical history of chronic hepatic failure | 0.49 [0.31–0.77] | .002 |
Medical history of COPD | 1.91 [1.48–2.47] | < .001 |
Hospitalizations during the previous year | 1.17 [0.96–1.42] | .10 |
Hyperpolypharmacy | 2.21 [1.77–2.77] | < .001 |
Non-independent livingc | 1.26 [0.98–1.63] | .06 |
Main reason for hospital admission (reference: surgical)d - Medical | 1.09 [0.82–1.45] | .55 |
Point-prevalence of DDIs over time
Changes in prevalence of DDIs at 2 months compared to baseline
Variables at baselinea | OR (95% CI) | P value |
---|---|---|
Decrease in DDI | ||
Sex (reference: female) | ||
Male | 0.76 [0.59–0.98] | .03 |
Site (reference: Bern) | ||
- Louvain | 1.24 [0.87–1.74] | .22 |
- 1Utrecht | 1.12 [0.80–1.55] | .51 |
- Cork | 0.70 [0.47–1.02] | .06 |
Medical history of depression | 1.69 [1.14–2.48] | .008 |
Medical history of atrial fibrillation | 1.29 [0.99–1.67] | .05 |
Medical history of coronary heart disease | 1.17 [0.90–1.53] | .23 |
Medical history of heart failure | 1.37 [1.04–1.81] | .03 |
Medical history of COPD | 1.21 [0.88–1.63] | .23 |
Medical history of cancer | 0.80 [0.58–1.07] | .14 |
Hyperpolypharmacyb | 2.02 [1.44–2.88] | < .001 |
Increase in DDI | ||
Site (reference: Bern) | ||
- Louvain | 0.72 [0.50–1.02] | .07 |
- Utrecht | 0.69 [0.50–0.95] | .02 |
- Cork | 0.53 [0.37–0.74] | < .001 |
Medical history of dementia | 1.18 [0.75–1.85] | .46 |
Medical history of depression | 1.30 [0.88–1.90] | .17 |
Medical history of atrial fibrillation | 2.01 [1.59–2.55] | < .001 |
Medical history of coronary heart disease | 1.29 [1.01–1.64] | .04 |
Medical history of cardiac failure | 1.79 [1.39–2.30] | < .001 |
Medical history of chronic renal failure | 0.85 [0.65–1.10] | .23 |
Medical history of bleeding | 1.29 [0.93–1.77] | .11 |
Hyperpolypharmacyb | 1.74 [1.29–2.37] | < .001 |
ADL | 0.95 [0.87–1.03] | .19 |
Main reason for hospital admission (reference: surgical) | ||
- Medical | 1.32 [0.90–1.97] | .16 |
Total N = 1950 | At least one DDI at baselinea N = 1045 | No DDI at baselinea N = 905 | Missing values | P value | |
---|---|---|---|---|---|
Age (years) | |||||
Median (IQR) | 79 [74–84] | 78 [74–83] | 79 [74–85] | 0 | .13 .25 |
70–79 | 1053 (54) | 582 (56) | 471 (52) | ||
80–89 | 757 (39) | 393 (37) | 364 (40) | ||
> 90 | 140 (7) | 70 (7) | 70 (8) | ||
Male | 1080 (55) | 558 (53) | 522 (58) | 0 | .06 |
Trial site | |||||
Louvain, Belgium | 385 (20) | 206 (20) | 179 (20) | 0 | .25 |
Cork, Ireland | 328 (17) | 171 (16) | 157 (17) | ||
Utrecht, The Netherlands | 433 (22) | 250 (24) | 183 (20) | ||
Bern, Switzerland | 804 (41) | 418 (40) | 386 (43) | ||
Medical history | |||||
Dementia | 116 (6) | 65 (6) | 51 (6) | 0 | .65 |
Depression | 173 (9) | 132 (13) | 41 (5) | < .001 | |
Stroke | 410 (21) | 207 (20) | 203 (22) | .17 | |
Hypertension | 1282 (66) | 675 (65) | 607 (67) | .27 | |
Atrial fibrillation | 697 (36) | 436 (42) | 261 (29) | < .001 | |
Diabetes | 628 (32) | 346 (33) | 282 (31) | .38 | |
Coronary artery disease | 661 (34) | 385 (37) | 276 (31) | .004 | |
Heart failure | 500 (26) | 333 (32) | 167 (19) | < .001 | |
Chronic renal failure | 522 (27) | 302 (29) | 220 (24) | .03 | |
Chronic hepatic failure | 98 (5) | 41 (4) | 57 (6) | .02 | |
COPD | 375 (19) | 258 (25) | 117 (13) | < .001 | |
Cancer | 482 (25) | 249 (24) | 233 (26) | .35 | |
Bleeding | 250 (13) | 137 (13) | 113 (12) | .73 | |
Thromboembolic disease | 236 (12) | 133 (13) | 103 (11) | .40 | |
Number of comorbidities | 11 [8–16] | 11 [8–16] | 11 [8–15] | .002 | |
Medications on index admission | |||||
Number of drugs per day | 12 [9–16] | 14 [11–18] | 11 [8–14] | 0 | < .001 |
Hyperpolypharmacyb | 1458 (75) | 873 (83) | 585 (65) | ||
Any hospitalizations during the previous year Number of hospitalizations during the previous year | 986 (51) 1 [0–1] | 566 (54) 1 [0–2] | 420 (46) 0 [0–1] | 0 | .001 < .001 |
Not living independentlyc | 375 (19) | 222 (21) | 153 (17) | 0 | .02 |
ADL6 score | 5.5 [4.5–6.0] | 5.5 [4.5–6.0] | 5.5 [4.5–6.0] | 32 | .61 |
Education level | |||||
Less than high school education | 573 (30) | 326 (32) | 247 (28) | 24 | .16 |
High-school degree | 886 (46) | 463 (45) | 423 (47) | ||
Post-secondary degree | 467 (24) | 243 (23) | 224 (25) | ||
Type of admission | |||||
Electived | 473 (24) | 243 (23) | 230 (25) | 0 | .29 |
Non-elective | 1477 (76) | 802 (77) | 675 (75) | ||
Main reason for hospital admission | |||||
Surgical | 257 (13) | 120 (11) | 137 (15) | 0 | .02 |
Medical | 1693 (87) | 925 (89) | 768 (85) |