Study of potential interactions of oral antidiabetic drugs in patients with type 2 diabetes mellitus with comorbidities: A retrospective study

Abstract

Background: Diabetes mellitus (DM) has many complications, such as microvascular and macrovascular complications. Patients are given polypharmacy therapy to combat these issues, which can cause drug interactions. Oral antidiabetic drugs were chosen based on their risk profile. Risk assessment aided treatment intensity targeting. The number of drugs taken can increase the risk of drug interactions causing health issues.    Objective: To identify potential drug interactions based on their severity (major, moderate and minor) and the mechanism of the drug interaction (pharmacokinetics and pharmacodynamics), in type two diabetes mellitus patients with comorbidities at the Lamongan Health Center.     Methods: This was a cross-sectional study using medical records and patient prescriptions from October 2020 to June 2021 at Puskesmas (Primary Health Centers) Deket, Karanggeneng, and Babat. The data were descriptively analysed. Drug interactions were analysed using drugs.com and Stockley. Purposive sampling was used to select 194 patients for inclusion.     Results: From October 2020 to June 2021, 110 out of 194 outpatients at Lamongan Regional Health Center had potential drug interactions (56.7 %). The most common type of drug interaction was of moderate severity, with 120 cases (93.0%), and the most common mechanism was pharmacodynamics (61.2%).    Conclusion: Polypharmacy is a difficult problem to avoid, so drug therapy monitoring is required in diabetic patients to minimise unwanted effects. Preventing potential drug interactions requires a system for early detection of potential drug interactions that may occur in patient prescribing and maximising pharmaceutical care. This system would allow for the community to be more proactive in finding out about potential drug interactions.