Vol.:(0123456789) 1 3 Aging Clin Exp Res DOI 10.1007/s40520-017-0755-2 ORIGINAL ARTICLE The impact of polypharmacy and drug interactions among the elderly population in Western Sicily, Italy Giulia Scondotto 1  · Fanny Pojero 1  · Sebastiano Pollina Addario 2  · Mauro Ferrante 3  · Maurizio Pastorello 4  · Michele Visconti 4  · Salvatore Scondotto 2  · Alessandra Casuccio 1   Received: 13 March 2017 / Accepted: 31 March 2017 © Springer International Publishing Switzerland 2017 and p = 0.012 vs age 14–64, respectively). Regarding con- traindicated DDIs a signifcant diference was detected comparing 14–64 vs ≥65 age groups (p = 0.010 vs 65–69 group, p = 0.005 vs 70–74 group and ≥75 group). Conclusions Polypharmacy is a phenomenon acquiring increasing dimensions also in our province. It interests par- ticularly the older subjects, and assumes a dramatic accent when it is put in relationship with the frequency of DDIs. A proactive vigilance about potential life threatening drug interactions is mandatory. Keywords Polypharmacy · Drug interactions · Elderly population · Drug prescriptions · Contraindicated drug– drug interactions Introduction The term “polypharmacy” is used to indicate the multiple medication consumption in the same or diferent thera- peutic areas by a patient, and it is adopted to defne both necessary and inappropriate/excessive prescriptions of diverse medications [1–22]. Such an expression to identify combined therapeutical approaches was frst introduced more than 150 years ago [21], and it is particularly difused referring to the elderly, who need to be treated for chronic pathologies with targeted strategies [1–21]. Obviously, the association of multiple classes of drugs is accompanied by an augmented risk of adverse reactions, which increases in parallel with the number of administered drugs (even with an exponential trend) as a consequence of the pharmacoki- netic and pharmacodynamic interactions of the used sub- stances [5, 7, 17–20]. In literature, the distinction between a “minor polypharmacy” (2–4 drugs) and “major polyphar- macy” (5 ≥ drugs) is common [22]. Abstract Aim Primary endpoint was to report polypharmacy dis- tribution in the general population vs ≥65 years old people and to examine the frequency of drug–drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in rela- tionship with patients’ age. Methods Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into fve age groups (0–13, 14–64, 65–69, 70–74, and ≥75 year old). The detection of potential DDIs in polypharmacy profles was performed with NavFarma software (Infologic srl, Padova, Italia), with DDI classifcation provided by tool Micromedex Drug Reax (Truven Health Analitics, Michi- gan, USA). Results We analyzed data of 1,324,641 patients, and 15,801,191 medical prescription were recorded; of these, 11,337,796 regarded chronic conditions. The drug prescrip- tions reached the highest values in the 65–69 and 70–74 age groups (p = 0.005 and p = 0.008 vs age 14–64 respectively). An overall amount of 6,094,373 DDIs were detected, of which 47,173 were contraindicated. Median number of DDIs was higher in 65–69 and 70–74 age groups (p = 0.008 * Alessandra Casuccio alessandra.casuccio@unipa.it 1 Dipartimento di Scienze per la Promozione della Salute e Materno Infantile “G. D’Alessandro” Università di Palermo, Palermo, Italy 2 Dipartimento Attività Sanitarie e Osservatorio Epidemiologico, Regione Siciliana, Palermo, Italy 3 Dipartimento Culture e Società, Università di Palermo, Palermo, Italy 4 Dipartimento Farmaceutico, ASP Palermo, Palermo, Italy