Drug–disease interactions in Swedish senior primary care patients were dominated by non-steroid anti-inflammatory drugs and hypertension – a population-based registry study

Figures & data

Table 1. 31 drug–disease interactions that were assessed for their prevalence.

STOPP- criteria	Interacting drug	ATC	Interacting disease	ICD-10 and assessment period
B8	Thiazide diuretic	C03A	gout	M10 ≥once 2012–2016
B9	Loop diuretic	C03CA	urinary incontinence	N39.3, N39.4 ≥once 2012–2016
C2	(Low-dose) acetylsalicylic acid without proton-pump-inhibitor	B01AC06, A02BC acetylsalicylic acid ≥ once 2016 but no proton-pump-inhibitor 2016	peptic ulcer disease	K25-28 ≥once 2015–2016
C2	Acetylsalicylic acid without proton-pump-inhibitor	N02BA, A02BC acetylsalicylic acid ≥ once 2016 but no proton-pump-inhibitor 2016	peptic ulcer disease	K25-28 ≥once 2015–2016
D1	Tricyclic antidepressants	N06AA	dementia	F00-03, G30 ≥once 2012–2016
D1	Tricyclic antidepressants	N06AA	narrow angle glaucoma	H40.2 ≥once 2012–2016
D1	Tricyclic antidepressants	N06AA	benign prostate hyperplasia	N40 ≥once 2012–2016
D3	Neuroleptics with moderate-marked antimuscarinic/anticholinergic effects	N05AH02, N05AF01, N05AB02, N05AF05	benign prostate hyperplasia	N40 ≥once 2012–2016
D6	Antipsychotics (i.e. other than quetiapine or clozapine)	N05AA, N05AB, N05AD, N05AE, N05AF	M Parkinson	G20 ≥once 2012–2016
D8	Anticholinergic drugs	A03AB, A03BA, A03BB, A04AD, C01BA,N02AG, N04A, N05AA, N05AF03, N05AH02, N05BB01, N06AA, R06AA02, R06AB, R06AD, R06AX02	dementia	F00-03, G30 ≥once 2012–2016
E4	NSAIDs	M01A without M01AX05	impaired renal function	N18.3-18.5, N18.9 N19.9 ≥once 2012–2016
F1	Prochlorperazine or metoclopramide	A03FA01	M Parkinson	G20 ≥once 2012–2016
F3	Anticholinergic/antimuscarinic drugs	A03AB, A03BA, A03BB, A04AD, C01BA,N02AG, N04A, N05AA, N05AF03, N05AH02, N05BB01, N06AA, R06AA02, R06AB, R06AD, R06AX02, G04BD	constipation	K59 ≥once 2015 AND ≥ once 2016
F3	Oral iron	B03A	constipation	K59 ≥once 2015 AND ≥ once 2016
F3	Opioids	N02A	constipation	K59 ≥once 2015 AND ≥ once 2016
F3	Verapamil	C08DA01	constipation	K59 ≥once 2015 AND ≥ once 2016
F3	Aluminium antacids	A02AD01	constipation	K59 ≥once 2015 AND ≥ once 2016
G3	Anti-muscarinic bronchodilators	R03BB01, R03BB04	narrow angle glaucoma	H40.2 ≥once 2012–2016
G3	Anti-muscarinic bronchodilators	R03BB01, R03BB04	benign prostate hyperplasia	N40 ≥once 2012–2016
G4	Benzodiazepines	N05BA, N05BA01, N05CD02, N05CD03	obstructive sleep apnea	G47.3 ≥once 2012–2016
H1	Non-COX-2 selective NSAIDs without proton-pump-inhibitor or H2-blockers	M01AB, M01AC, M01AE, M01AX01	peptic ulcer disease	K25-28 ≥once 2015–2016
H2	NSAIDs	M01A without M01AX05	hypertension	I10-15 ≥once 2012–2016
H2	NSAIDs	M01A without M01AX05	heart failure	I50 ≥once 2012–2016
H7	COX-2 selective NSAIDs	M01AH, M01AB05	concurrent cardiovascular disease (coronary heart disease, peripheral arterial disease, cerebrovascular disease, TIA)	I20-25, I70-79, I63.0-I63.9, I61.0-I61.9, I64, G45.9, Z86.6A ≥ once 2012–2016
H9	Oral bisphosphonates	M05BA, M05BB	history of upper gastrointestinal disease i.e. dysphagia, oesophagitis, gastritis, duodenitis, or peptic ulcer disease, or upper gastrointestinal bleeding	K20-K29, K31 ≥once 2015 − 2016
I1	Antimuscarinic drugs	G04BD	dementia	F00-03, G30 ≥once 2012–2016
I1	Antimuscarinic drugs	G04BD	narrow-angle glaucoma	H40.2 ≥once 2012–2016
I1	Antimuscarinic drugs	G04BD	benign prostate hyperplasia	N40 ≥once 2012–2016
J2	Thiazolidenediones	A10BG	heart failure	I50 ≥once 2012–2016
J4	Oestrogens	G03C (only oral)	breast cancer	C50 ≥once 2012–2016
J4	Oestrogens	G03C (only oral)	venous thromboembolism	I26, I82 ≥once 2012–2016

Figure 1. Time frames for assessment of diseases.

GERD: Gastroesophageal reflux disease

Table 2. Basic characteristics of study population (n = 336,295).

	Total	% (if not indicated otherwise)
Age in years	65–74	59.9
	75–84	28.6
	85 and older	11.6
Morbidity^a	Cardiovascular disease^b	59.4
	Cancer	17.8
	Diabetes	15.4
	Chronic respiratory diseases^c	12.2
	Cerebrovascular disease^d	7.4
Healthcare consumption	Median nr of visits with GP (IQR)	4 (2;9)
	Median nr of emergency department visits (IQR)	0 (0;1)

^a 1 January 2012 to 31 December 2016.

^b Hypertension, coronary heart disease, heart failure, atrial fibrillation, peripheral arterial disease.

^c Chronic obstructive pulmonary disease, asthma.

^d Stroke, transient ischemic attack.

Figure 2. (a,b) Number of patients with drug-disease interaction in the total population (2a) and grouped by interacting disease (2 b) (total population n = 336,295). For corresponding numbers: see appendix, Tables 2 and 3. (a) Prevalence of the 20 most commonly seen drug-disease interactions.

Figure 3. Prevalence differences and 95% confidence intervals of NSAID use in patients with a pain diagnosis and with/without an interacting disease.