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Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

机译：巴西精神卫生服务中潜在药物相互作用的分析：患病率和相关因素

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Background: In the mental health field, the psychotropic polypharmacy is frequently observed, a significant risk factor for the occurrence of drug interactions. Objective: Identify potential drug interactions on the prescriptions of mental health services users and describe the associated factors. Methods: A cross-sectional study was conducted in 11 services. Sociodemographic data and information about the use of drug were obtained through interviews of users, analysis of prescriptions and medical charts, using a semi-structured questionnaire. Potential drug interactions were identified using the Micromedex? database, the association with sociodemographic characteristics and aspects related to the medicines prescribed were analyzed using the prevalence ratio. Results: The number of medicines prescribed ranged from 0 to 9, with an average of 3.38 (SD=1.76) per user, the most prescribed being haloperidol (12.3%), clonazepam (8.2%) and biperiden (7.9%). The proportion of interactions considering the number of users interviewed was 35.1%. The most frequent between potential interactions were haloperidol and fluoxetine (9.1%); haloperidol and carbamazepine (8.8%); and carbamazepine and chlorpromazine (5.9%). The highest prevalence ratio (PR) for the occurrence of potential interactions was in women (PR=1.36; 95% CI 1.08:1.71), users who had reported improper medicine use (PR=1.36; 95% CI: 1.07:1.72) and those with more than 5 prescribed medicines (PR=1.87; 95% CI: 1.49:2.33). Conclusion: Potential drug interactions were observed in more than one-third of the user’s Brazilian mental health services. The profile of interactions detected could guide the pharmacotherapeutic follow-up of priority users, and help the multidisciplinary team identify signs and symptoms that can influence the treatment of users.
机译：背景：在精神卫生领域，经常会观察到精神药物混合药，这是发生药物相互作用的重要危险因素。目的：根据精神卫生服务使用者的处方确定潜在的药物相互作用，并描述相关因素。方法：在11个服务部门进行了横断面研究。社会人口统计学数据和有关药物使用的信息是通过对用户的采访，处方分析和病历分析以及半结构化问卷获得的。使用Micromedex识别潜在的药物相互作用。数据库中，使用患病率分析了与社会人口学特征的关联以及与所处方药物有关的方面。结果：处方药的数量从0到9不等，每位使用者平均使用3.38（SD = 1.76），其中处方最多的是氟哌啶醇（12.3％），氯硝西am（8.2％）和比哌立定（7.9％）。考虑受访用户数量的互动比例为35.1％。潜在相互作用之间最频繁的是氟哌啶醇和氟西汀（9.1％）;氟哌啶醇和卡马西平（8.8％）;以及卡马西平和氯丙嗪（5.9％）。发生潜在相互作用的最高患病率（PR）是女性（PR = 1.36; 95％CI 1.08：1.71），报告用药不当的使用者（PR = 1.36; 95％CI：1.07：1.72）和处方药多于5种的患者（PR = 1.87; 95％CI：1.49：2.33）。结论：在巴西使用者的心理健康服务中，超过三分之一的人都发现了潜在的药物相互作用。检测到的相互作用的概况可以指导优先用户的药物治疗随访，并帮助多学科团队识别可能影响用户治疗的体征和症状。

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