Лікопов’язані проблеми у коморбідних пацієнтів з тривожно-депресивними розладами

Drug-related problems (DRPs) pose a significant threat to patient safety, especially in conditions of comorbidity and polypharmacy. DRPs can manifest as adverse reactions, drug interactions, etc., potentially negatively affecting the effectiveness and safety of treatment. Since most DRPs are potentially predictable if timely detection and correction of pharmacotherapy are provided, the role of the clinical pharmacist is increasing, who can be included in the interdisciplinary team of specialists and, within the framework of pharmaceutical counselling, contribute to their minimization. The aim: The aim of our study was to assess the frequency and nature of DRPs in comorbid patients with anxiety and depressive disorders to develop a model of pharmaceutical counselling. Materials and methods: A retrospective analysis of 55 medical histories of comorbid patients who were inpatients in the therapeutic department of a multidisciplinary hospital in Kyiv and were treated for the main disease and anxiety-depressive disorders was conducted. Most patients (67%) had 3–4 concomitant diseases, including anxiety-depressive disorder, in addition to the main one. The analysis of potential drug-drug interactions was carried out using the DrugBank database and official instructions for medical use of medicines. Statistical analysis included correlation analysis to assess the relationships between variables and comparison of qualitative indicators using the Pearson χ² test. The level of statistical significance was taken as p < 0.05. Data processing was carried out using the Microsoft Excel package. Results: The total frequency of DRPs per patient was 3.73 ± 2.58, polypharmacy was detected in 84% of patients. A significant correlation (p < 0.05) was found between the patient's age and the number of comorbid conditions (r = 0.48), as well as between the patient's age and the number of medications he received (r = 0.45). Patients were significantly more likely to receive benzodiazepines than antidepressants (89.1% vs. 38.2%; Pearson's χ² = 30.80, p < 0.001). Conclusions: Among comorbid patients with anxiety and depressive disorders who were treated in a somatic hospital, a significant prevalence of drug-related problems was found. The number of drugs per course of treatment correlated with the age of the patients. Almost all patients received benzodiazepines, including the majority of elderly patients, which is dangerous due to the risk of increasing cognitive impairment. In addition, clinically significant drug-drug interactions were found in 42% of patients, and in 29% – the prescription of drugs in the presence of restrictions or contraindications. The results of the study emphasize the importance of individualizing pharmacotherapy considering age, comorbidity and potential interactions and justify the need to involve a clinical pharmacist in a multidisciplinary team to minimize the risk of drug-related problems