Rationale, design, and methodology of the EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2019; 47(5): 391-398 | DOI: 10.5543/tkda.2019.27724

Rationale, design, and methodology of the EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study

Eda Özlek1, Edip Güvenç Çekiç2, Bülent Özlek1, Cem Çil1, Oğuzhan Çelik1, Volkan Doğan1, Özcan Başaran1, Veysel Ozan Tanık3, Halil İbrahim Özdemir4, Yunus Çelik5, Caner Kaçmaz6, Zeki Şimşek7, Hacı Murat Güneş8, Özgen Şafak9, Buğra Özkan10, Onur Tasar11, Çağatay Önal12, Lütfü Bekar13, Murat Biteker1
1Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
2Department of Pharmacology, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
3Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
4Department of Cardiology, Nizip State Hospital, Gaziantep, Turkey
5Department of Cardiology, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Turkey
6Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
7Department of Cardiology, Tuzla State Hospital, İstanbul, Turkey
8Department of Cardiology, Medipol University Faculty of Medicine, İstanbul, Turkey
9Department of Cardiology, Burdur State Hospital, Burdur, Turkey
10Department of Cardiology, Mersin University Faculty of Medicine, Mersin, Turkey
11Department of Cardiology, Elazığ Training and Research Hospital, Elazığ, Turkey
12Department of Cardiology, Bulanık State Hospital, Muş, Turkey
13Department of Cardiology, Hitit University Çorum Erol Olcok Training and Research Hospital, Çorum, Turkey


OBJECTIVE
The aim of this study is to assess the prevalence of polypharmacy, inappropriate drug use, and drug-drug interactions (DDIs) in elderly patients presenting at outpatient cardiology clinics in Turkey.

METHODS
The EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study will be an observational, real-world, multicenter study conducted to evaluate DDIs and polypharmacy in elderly cardiac outpatients. All consecutive patients (aged ≥65 years) admitted to outpatient cardiology clinics between July 30, 2018 and July 30, 2019 who provide written, informed consent will be enrolled. A total of approximately 5000 patients are to be enrolled in this non-interventional study. All of the data will be collected at one point in time and current clinical practice will be evaluated (ClinicalTrials.gov NCT03370523).

RESULTS
Patient demographics, comorbid disease characteristics, laboratory test results, and details of medication use will be collected using self-reports and medical records. The severity of comorbid disease will be recorded and scored according to Charlson Comorbidity Index (CCI) and patients will be divided into 3 groups: mild, those with a CCI score of 1–2; moderate, those with a CCI score of 3–4; and severe, those with a CCI score of ≥5. Polypharmacy will be defined as the use of 5 or more medications at one time. DDIs will be determined using the Lexicomp Online drug interaction screening tool and potentially inappropriate medications will be defined based on the 2015 update of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Severe drug interactions will be defined as those in category D or X.

CONCLUSION
EPIC will be the first large-scale study in Turkey to evaluate polypharmacy, potentially inappropriate medications, and DDIs in elderly cardiac outpatients in a real-world clinical setting.

Keywords: Cardiac outpatients, drug-drug interactions; elderly; polypharmacy.

How to cite this article
Eda Özlek, Edip Güvenç Çekiç, Bülent Özlek, Cem Çil, Oğuzhan Çelik, Volkan Doğan, Özcan Başaran, Veysel Ozan Tanık, Halil İbrahim Özdemir, Yunus Çelik, Caner Kaçmaz, Zeki Şimşek, Hacı Murat Güneş, Özgen Şafak, Buğra Özkan, Onur Tasar, Çağatay Önal, Lütfü Bekar, Murat Biteker. Rationale, design, and methodology of the EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study. Turk Kardiyol Dern Ars. 2019; 47(5): 391-398

Corresponding Author: Bülent Özlek, Türkiye
© Copyright 2019 Archives of the Turkish Society of Cardiology
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