Evaluation of emergency room patients with a history of multiple drug use; Suitability and risks

Aim: Polypharmacy, defined as the use of five or more drugs, is an increasingly important public health problem. As the number of drugs used increases, the risk of drug-drug interactions also increases. The aim of our study is to determine the demographic characteristics of emergency room patients using multiple drugs, discrepancy among prescription/nonprescription drugs and the frequency of risky drug intake. Materials and Methods: The study was conducted prospectively between 01.03.2019 and 31.08.2019 at Zonguldak Bülent Ecevit University Faculty of Medicine. Of patients using 5 or more drugs and aged 18 years or over, those who accepted to participate in the study was included in this study. The case report form was filled. Drug interactions in multi-drug use were investigated in the ''UpToDateRLexicompR Drug Interactions'' database. The data were statistically analyzed by using R. 3.2.2.2 package program. Results: Of 700 patients included in the study, 422 (60.3%) were female and 278 (39.7%) were male. The mean age was 66.92±12.18 years. Among all, the group of patients using 5-8 drugs was the most frequent with a rate of 78%. Cardiovascular diseases were in the first place among the patients included in the study. The first three most prevalent drugs were established as antihypertensive, antiulcer and antiplatelet drugs, respectively. Drug interactions were detected in 273 (39%) patients in category D requiring close follow-up, and in 71 (10.1%) patients in category X, to be avoided. Conclusion: In category D, which requires close follow-up, antiepileptics, analgesics and insulin ranked in the top three. In category X, which needed to be avoided, antiepileptics, inhaler drugs, antibiotics and benign prostate hyperplasia drugs ranked in the top three.