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Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

Adverse drug interactions increase morbidity and mortality. To prevent these, situations leading to adverse prescriptions must be clarified. This study quantifies and analyses prescriptions with potential adverse drug interactions in primary health care in the north of France over a 3-month period.

Methods

All prescriptions administered between 1 January and 31 March 1999 were analysed to identify potential interactions amongst drugs appearing on the same prescription sheet. The regional French healthcare database was compiled to further classify contra-indications.

Results

There were 5,358,374 prescriptions administered to 44% of the overall population of the Nord-Pas de Calais area (1,754,372 patients/3,990,167 general population). There were 14,390 prescriptions classified as either absolute (26%) or relative contraindications (74%). Nine drug categories accounted for most of the absolute contraindications: dopaminergic antiparkinsonians, neuroleptic agents, migraine treatments (such as ergot alkaloids, sumatriptan and other triptan derivatives), prokinetic drugs (cisapride), antibacterial drugs (macrolides), antifungals (imidazoles), antiarrhythmics, betablockers and analgesics (opioids and floctafenine). In 54% of patients exposed, the incurred risk was either QT prolongation/Torsade de Pointes or antagonism of dopaminergic antiparkinson agents with dopamine receptor antagonists prescribed as antipsychotic agents.

Conclusions

Among a non-selected population of ambulatory outpatients, the number of quarterly prescriptions with contra-indications with potentially harmful drug interaction was 27 in 10,000 prescriptions. This would extrapolate to nearly 200,000 contra-indications on the same-prescription sheets in France in the first quarter of 1999.

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Author information

Authors and Affiliations

  1. Department of Pharmacology, University of Lille, France

    Laurence Guédon-Moreau & Jacques Caron

  2. Faculte de Medecine, Service de Pharmacologie, 2 Avenue Oscar Lambret, 59037, Lille, France

    Laurence Guédon-Moreau

  3. Assurance Maladie, Echelon local du service medical, Roubaix, France

    Dominique Ducrocq & Yves Quieureux

  4. Assurance Maladie, Echelon régional du service medical, Lille, France

    Marie-Francoise Duc

  5. Mutualité sociale agricole, Pas de Calais, France

    Catherine L’Hôte

  6. Assurance maladie des professions independantes, Lille, France

    Jean Deligne

Authors
  1. Laurence Guédon-Moreau
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  2. Dominique Ducrocq
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  3. Marie-Francoise Duc
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  4. Yves Quieureux
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  5. Catherine L’Hôte
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  6. Jean Deligne
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  7. Jacques Caron
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Corresponding author

Correspondence to Laurence Guédon-Moreau.

Additional information

The work is also attributed to the following institutions: Union Regionale des Caisses d’Assurance Maladie du Nord Pas de Calais. Villeneuve d’Ascq, France; and Department of Pharmacology University of Lille, France.

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Guédon-Moreau, L., Ducrocq, D., Duc, MF. et al. Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999. Eur J Clin Pharmacol 59, 689–695 (2003). https://doi.org/10.1007/s00228-003-0684-1

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  • DOI: https://doi.org/10.1007/s00228-003-0684-1

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