Prevalence of cardiovascular drug-related adverse drug reactions consultations in UK primary care: A cross-sectional study

• Published in: PloS one Vol. 19; no. 7; p. e0307237
• Main Authors: Insani, Widya N, Whittlesea, Cate, Wei, Li
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24-07-2024; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Analysis; Angina pectoris; Anticoagulants; Antihypertensive drugs; Antihypertensives; Aspirin; Beta blockers; Cardiovascular Agents - adverse effects; Cardiovascular Agents - therapeutic use; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Cerebral infarction; Chronic obstructive pulmonary disease; Comorbidity; Complications and side effects; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Disease prevention; Diuretics; Drug abuse; Drug therapy; Drug-Related Side Effects and Adverse Reactions - epidemiology; Dyslipidemia; Female; Health care; Health services; Heart attack; Humans; Hypertension; Lipids; Male; Medical records; Medical research; Medicine and Health Sciences; Medicine, Experimental; Metabolic disorders; Middle Aged; Mortality; Myocardial infarction; Older people; Patient compliance; Patients; Polypharmacy; Prescription drugs; Prevalence; Primary care; Primary Health Care - statistics & numerical data; Referral and Consultation; Regression models; Rheumatic diseases; Risk Factors; Side effects; Standardization; Statins; Transient ischemic attack; Type 2 diabetes; United Kingdom - epidemiology; Young Adult; United Kingdom; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0307237

Adverse drug reactions (ADRs) represent a significant barrier to achieve optimal treatment outcomes. Cardiovascular drugs, including antihypertensive drugs, lipid-lowering drugs, and antithrombotic drugs, are among the most prescribed medications in the primary care setting.
To estimate the prevalence of cardiovascular drug-related ADRs consultations in United Kingdom (UK) primary care and identify risk factors of these ADRs.
This was a cross-sectional study of cardiovascular drug users between 2000-2019 using UK IQVIA Medical Research Data. ADRs consultations were identified using database screening method employing standardised designated codes. The overall and annual age-standardised prevalence was estimated using direct standardisation method using 2019 mid-year UK population. Risk factors of ADRs consultations were estimated using logistic regression model stratified by therapeutic areas.
The standardised prevalence of consultations related to cardiovascular drugs ADRs was 10.60 (95% CI. 10.46, 10.75) per 1000 patients. Patients aged 70-79 years had the highest occurrence of ADRs consultations. The most frequently drug classes implicated in the ADRs consultations were statins (n = 9,993 events, 27.09%), beta-blockers (n = 8,538 events, 23.15%), ACEIs/ARBs (n = 8,345 events, 22.62%), and aspirin (n = 6,482 events, 17.57%). Risk factors of ADRs consultations were previous history of cardiovascular diseases, e.g., myocardial infarction and stroke; advanced age, comorbidities; diabetes and dyslipidaemia; and polypharmacy.
The burden of cardiovascular drug-related ADRs consultations in primary care was considerable. Statins, beta-blockers, ACEIs/ARBs, and aspirin were the most frequently implicated drug classes. Closer clinical monitoring should be performed for patients affected by the ADRs to mitigate the risk of suboptimal treatment outcomes.