Are patients with a nasally placed feeding tube at risk of potential drug-drug interactions?: A multicentre cross-sectional study

Fernanda Raphael Escobar Gimenes, Melissa Baysari, Scott Walter, Leticia Alves Moreira, Rhanna Emanuela Fontenele Lima de Carvalho, Adriana Inocenti Miasso, Fabiana Faleiros, Johanna Westbrook

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aims: The primary aims were to determine the rate of potential drug-drug interactions (pDDIs) in patients with nasally placed feeding tubes (NPFT) and the factors significantly associated with pDDIs. The secondary aim was to assess the change in pDDIs for patients between admission and discharge. Material and methods: This multicentre study applied a cross-sectional design and was conducted in six Brazilian hospitals, from October 2016 to July 2018. Data from patients with NPFT were collected through electronic forms. All regular medications prescribed were recorded. Medications were classified according to the World Health Organization (WHO) Anatomical Therapeutic Chemical code. Drug-drug interaction screening software was used to screen patients’ medications for pDDIs. Negative binomial regression was used to account for the over dispersed nature of the pDDI count. Since the number of pDDIs was closely related to the number of prescribed medications, we modelled the rate of pDDIs with the count of pDDIs as the numerator and the number of prescribed medications as the denominator; six variables were considered for inclusion: time (admission or discharge), patient age, patient gender, age-adjusted Charlson Comorbidity Index (CCI) score, type of prescription (electronic or handwritten) and patient care complexity. To account for correlation within the two time points (admission and discharge) for each patient a generalised estimating equations approach was used to adjust the standard error estimates. To test the change in pDDI rate between admission and discharge a full model of six variables was fitted to generate an adjusted estimate. Results: In this study, 327 patients were included. At least one pDDI was found in more than 91% of patients on admission and discharge and most of these pDDIs were classified as major severity. Three factors were significantly associated with the rate of pDDIs per medication: patient age, patient care complexity and prescription type (handwritten vs electronic). There was no evidence of a difference in pDDI rate between admission and discharge. Conclusion: Patients with a NPFT are at high risk of pDDIs. Drug interaction screening tools and computerized clinical decision support systems could be effective risk mitigation strategies for this patient group.

LanguageEnglish
Article numbere0220248
Pages1-14
Number of pages14
JournalPLoS ONE
Volume14
Issue number7
DOIs
Publication statusPublished - 1 Jan 2019

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Drug interactions
drug interactions
tube feeding
Enteral Nutrition
Drug Interactions
cross-sectional studies
Cross-Sectional Studies
drugs
Pharmaceutical Preparations
drug therapy
Patient Discharge
electronics
Preclinical Drug Evaluations
patient care
Patient Admission
Patient Care
Screening
Electronic Prescribing
Clinical Decision Support Systems
screening

Bibliographical note

Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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Gimenes, Fernanda Raphael Escobar ; Baysari, Melissa ; Walter, Scott ; Moreira, Leticia Alves ; de Carvalho, Rhanna Emanuela Fontenele Lima ; Miasso, Adriana Inocenti ; Faleiros, Fabiana ; Westbrook, Johanna. / Are patients with a nasally placed feeding tube at risk of potential drug-drug interactions? A multicentre cross-sectional study. In: PLoS ONE. 2019 ; Vol. 14, No. 7. pp. 1-14.
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Are patients with a nasally placed feeding tube at risk of potential drug-drug interactions? A multicentre cross-sectional study. / Gimenes, Fernanda Raphael Escobar; Baysari, Melissa; Walter, Scott; Moreira, Leticia Alves; de Carvalho, Rhanna Emanuela Fontenele Lima; Miasso, Adriana Inocenti; Faleiros, Fabiana; Westbrook, Johanna.

In: PLoS ONE, Vol. 14, No. 7, e0220248, 01.01.2019, p. 1-14.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Gimenes, Fernanda Raphael Escobar

AU - Baysari, Melissa

AU - Walter, Scott

AU - Moreira, Leticia Alves

AU - de Carvalho, Rhanna Emanuela Fontenele Lima

AU - Miasso, Adriana Inocenti

AU - Faleiros, Fabiana

AU - Westbrook, Johanna

N1 - Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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