Risk of emergency hospitalizations associated with exposure to drug-drug interactions

There is a 2.5-fold rise in emergency hospitalization risk due to drug-drug interactions. This large population-based study suggests the rational use of prescription practices of concomitant medicines for different contraindications to avoid drug-drug interactions and the risk of emergency hospitalizations.

To assess emergency hospitalization risk due to exposure to the contraindicated simultaneous use of interacting drugs in the population.

On the whole, 150,000 people picked randomly from the French national health insurance database participated in this self-controlled case-series examination. The exposure to the contraindicated simultaneous use of interacting drugs was regarded as the overlapping stage of dispensing of medications contraindicated due to drug–drug interactions.

The conditional Poisson regression model was used to estimate the key outcome, ratios of incidence rate, and comparison of incidence rate of emergency hospitalizations during each category of exposure span with respect to the reference span.

In this nationwide population-based study, 967 people were exposed to a minimum of 1 contraindicated simultaneous use of medicine. A total of 177 people were exposed and had at least one emergency hospitalization during the study period. The chances of emergency hospitalization increased subjected to contraindicated simultaneous use of interacting drug periods versus the unexposed time point  (incidence rate ratio: 2.41). This could interpret as 7200 (4500–8900) emergency hospitalizations that could have been prevented in a year.

Over 1 year, the participating population in France reported an almost 2.5-fold increase in the risk of emergency hospitalizations when exposed to concomitant use of medicines for contraindications, with a potential public health influence beyond 7000 hospitalizations that could have been averted.

There is a need to strengthen training in prescription practices and preventive measures concerning contraindicated concomitant use of medicines such as those which may increase in long QT syndrome (like Citalopram), and highly prescribed drugs with overdose risk if given along with cytochrome P450 inhibitors (like gout and lipid-lowering medicines).