Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/71610
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Major bleeding risk associated with warfarin and co-medications in the elderly population |
Author: | Vitry, A. Roughead, E. Ramsay, E. Preiss, A. Ryan, P. Gilbert, A. Caughey, G. Shakib, S. Esterman, A. Zhang, Y. McDermott, R. |
Citation: | Pharmacoepidemiology and Drug Safety, 2011; 20(10):1057-1063 |
Publisher: | John Wiley & Sons Ltd |
Issue Date: | 2011 |
ISSN: | 1053-8569 1099-1557 |
Statement of Responsibility: | Agnes I. Vitry, Elizabeth E. Roughead, Emmae N. Ramsay, Adrian K. Preiss, Philip Ryan, Andrew L. Gilbert, Gillian E. Caughey, Sepehr Shakib, Adrian Esterman, Ying Zhang and Robyn A McDermott |
Abstract: | <h4>Purpose</h4>Warfarin management in the elderly population is complex as medicines prescribed for concomitant diseases may further increase the risk of major bleeding associated with warfarin use. We aimed to quantify the excess risk of bleeding-related hospitalisation when warfarin was co-dispensed with potentially interacting medicines.<h4>Methods</h4>A retrospective cohort study was undertaken over a 4-year period from July 2002 to June 2006 to examine bleeding risk associated with medications co-administered in patients taking warfarin using an administrative claims database from the Australian Department of Veterans' Affairs. All veterans aged 65 years and over who were new users of warfarin were followed until death or study end. Risk of bleeding was assessed using a Poisson GEE model adjusting for age, gender, socioeconomic status, co-morbidity index, previous bleeding related hospitalisations and indicators of health service use.<h4>Results</h4>Overall, 17661 veterans who used warfarin at any time during the study period were included. The overall incidence rate of bleeding-related hospitalisations was 4.1 (95% CI 3.7-4.6) per 100 person-years in veterans who were not receiving potentially interacting medicines. Bleeding-related hospitalisation rates were significantly increased when warfarin was co-prescribed with low-dose aspirin (Adjusted rate ratio (AdjRR) 1.44, 95% CI 1.00-2.07), clopidogrel (AdjRR 2.23, 95% CI 1.48–3.36), clopidogrel with aspirin (AdjRR 3.44, 95% CI 1.28-9.23), amiodarone (AdjRR 3.33, 95% CI 1.38–8.00) and antibiotics (AdjRR 2.34, 95% CI 1.55-3.54).<h4>Conclusions</h4>Models assessing bleeding risk with warfarin should take account of the range of potentially harmful medicine combinations used in elderly people with comorbid conditions. |
Keywords: | Humans Atrial Fibrillation Hemorrhage Warfarin Anti-Inflammatory Agents, Non-Steroidal Anticoagulants Platelet Aggregation Inhibitors Drug Therapy, Combination Risk Risk Factors Retrospective Studies Cohort Studies Drug Interactions Databases, Factual Aged Aged, 80 and over Female Male Drug-Related Side Effects and Adverse Reactions |
Rights: | Copyright © 2011 John Wiley & Sons, Ltd. |
DOI: | 10.1002/pds.2219 |
Published version: | http://dx.doi.org/10.1002/pds.2219 |
Appears in Collections: | Aurora harvest 5 Public Health publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.