Prevalence and Associated Factors of Drug-Drug Interactions in Hospitalized Diabetic Patients: A Cross-Sectional Study

Abstract

Diabetes mellitus is a chronic metabolic condition frequently associated with complications and comorbidities that often require hospitalization for effective management. Such patients are often prescribed with multiple medications, which elevate the risk of potential drug-drug interactions (pDDIs). Hence, this study aims to determine the prevalence, severity, common interacting pairs, and factors associated with pDDIs among hospitalized diabetes patients. The study used a retrospective crosssectional study design conducted at Universitas Indonesia Hospital. Lexicomp® Lexi-InteractTM software was used to analyze and classify pDDIs. Logistic regression analysis was used to identify different factors associated with the presence of pDDIs. Among 200 patients included in the study, about half (50.5%) of the patients were male. The median age was 60 years, with an interquartile range of 52-69 years. PDDIs were observed in 89% of patients. A total of 966 interactions were found, of which 75.6% were moderate, 16.2% were minor, and 8.1% were of major severity. Meanwhile, in the risk rating C category, 71.0% were predominant, followed by B and D, 15.0% and 11.0%, respectively. Multivariate regression analysis showed a statistically significant association of pDDIs with 5–8 prescribed medicines (OR=22.8; 95% CI=5.5-94.7; p<0.001), >8 prescribed medicines (OR=64.4; 95% CI=11.3- 336.5; p<0.001). PDDIs are highly prevalent in diabetic patients. Moderate types of interaction with a risk rating of C and a reliability rating of fair are commonly found. The most common drug-interacting pairs are metformin + ondansetron and atorvastatin + amlodipine. Polypharmacy is observed as a risk factor for PDDIs occurrence. Keywords: prevalence; diabetes mellitus; drug-drug interaction; risk factor, Indonesia.