Incidence of drug-drug interactions in prescriptions of general practitioners and specialists in Bangladesh

Aim: Drug-drug interactions (DDI) can cause unexpected side effects, changes in drug efficacy, metabolism or overall action of any particular drug and DDI is one of the major prescription errors. DDI can be caused by using concomitant administration of a second drug. This study aims to find DDI in prescriptions of 10 different medical specializations of Bangladesh.

Study Design and Methodology: This study is based on the evaluation of prescription, type, and clinical significance of drug-drug interaction. For this study, 21088 prescriptions were evaluated from 45 different medical institutions and 10 different specializations including general practitioners, cardiologists, medicine specialists, general surgeons, gynecologists, ENT specialists, neurologists, urologists, pediatricians, and ophthalmologists. After the collection of prescriptions, all prescribed medications were checked by using several sources to point out the probable interactions.

Results: Among all the prescriptions most DDI was found from cardiologists (6.17%) and the least DDI was found from pediatricians (3.29%). Clopidogrel and warfarin were the most common medications causing drug interaction while drug interaction with cardiovascular drugs and antibiotics generic were most common among all. Polypharmacy, absence or shortage of pharmacists, workload, miscommunications and lack of knowledge were found as the leading causes of DDI.

Conclusion: Active participation of the pharmacist in crosschecking the prescribed medication, proper communication of the physician and patients, relevant workshops regarding DDI and distribution of the workload of the physicians in different levels can play a role in minimizing DDI.