Archives of the Turkish Society of Cardiology
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. Ahead of Print: TKDA-27724 | 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 ÇİL1, OĞUZHAN ÇELİK1, volkan doğan1, ozcan basaran1, VEYSEL OZAN TANIK3, Halil ibrahim Ozdemir4, Yunus Çelik5, caner kaçmaz6, Zeki Simsek7, HACI MURAT GUNES8, Özgen Şafak9, Buğra Özkan10, Onur Tasar11, ÇAĞATAY ÖNAL12, lütfü bekar13, MURAT BİTEKER1
1Department Of Cardiology, Mugla Sitki Kocman University, Faculty Of Medicine, Mugla, Turkey
2Department Of Pharmacology, Mugla Sitki Kocman University, Faculty Of Medicine, Mugla, Turkey
3Department Of Cardiology, Diskapi Yildirim Beyazit Training And Research Hospital, Ankara, Turkey
4Department Of Cardiology, Nizip State Hospital, Gaziantep, Turkey
5Department Of Cardiology, Kirikkale Yuksek İhtisas Hospital, Kirikkale, Turkey
6Department Of Cardiology, Mehmet Akif Ersoy Thoracic And Cardiovascular Surgery Training And Research Hospital, Istanbul, Turkey
7Department Of Cardiology, Tuzla State Hospital, Istanbul, Turkey
8Department Of Cardiology, Medipol University, Faculty Of Medicine, Istanbul, Turkey
9Department Of Cardiology, Burdur State Hospital, Burdur, Turkey
10Department Of Cardiology, Mersin University, Faculty Of Medicine, Mersin, Turkey
11Department Of Cardiology, Elazıg Training And Research Hospital, Elazıg, Turkey
12Department Of Cardiology, Bulanik State Hospital, Mus, Turkey
13Department Of Cardiology, Hitit University Corum Erol Olcok Training And Research Hospital, Corum, Turkey


OBJECTIVE
To assess the prevalence of polypharmacy, inappropriate drug use and drug-drug interactions (DDIs) in elderly patients presenting to a 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 and multicenter study to evaluate DDIs and polypharmacy in elderly cardiac outpatients. We will enroll all consecutive patients (aged ≥ 65 years) admitted to the outpatient cardiology clinics from July 30, 2018, through July 30, 2019, provided written informed consent. Approximately 5000 patients will be enrolled in this non-interventional study. All the data will be collected at one point in time and current clinical practice will be evaluated (ClinicalTrials.gov number NCT03370523).


RESULTS
Patient demographics, comorbid disease characteristics, laboratory test results and medications will be collected by self reports and medical records. The severity of comorbid diseases will be recorded and scored according to Charlson comorbidity index (CCI) and patients will be divided into three groups: mild, with CCI scores of 1–2; moderate, with CCI scores of 3–4; and severe, with CCI scores ≥5. Polypharmacy will be defined as being on five or more medications at one time, DDIs will be checked with Lexicomp® and potentially inappropriate medications will be defined with 2015 update of Beers criteria. Severe drug interactions will be defined with category D or X DIs.


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

Keywords: Cardiac outpatients, Drug-drug interactions, Elderly, Polypharmacy.

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