ArticlePatient preference and adherence2025
Influence of Potential Pharmacodynamic Drug Interactions in Pharmacotherapy of Coronary Heart Disease with Comorbid Conditions on Treatment Adherence: A Cross-Sectional Study of a Ukrainian Patient Cohort.
Article in Patient preference and adherence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Coronary heart disease (CHD) is accompanied by a high level of comorbidity, which necessitates the use of complex treatment regimens in pharmacotherapy. In such cases, multicomponent pharmacotherapy significantly increases the risk of pharmacological interactions, which can result in either enhanced therapeutic effects (synergism) or adverse outcomes (antagonism, toxic effects). These drug interactions may influence the level of adherence to treatment in patients with CHD with comorbid conditions. Purpose of the Study: To assess the systemic impact of potential drug-drug interactions (pDDI), classified by type of pharmacodynamic response (synergism, antagonism, toxicity), on adherence to pharmacotherapy in patients with CHD with comorbid conditions, with subsequent prediction of risks associated with reduced adherence to treatment. Materials and Methods: The study examined medical data of patients with CHD with comorbid conditions (n = 145) based on the analysis of prescriptions from hospital medical records for pDDI using standardized databases Medscape and Drugs.com. This study is cross-sectional, as it involved a single analysis of complex treatment regimens for drug compatibility and patient surveys conducted within the defined time frame (from October 2024 to June 2025). A survey of patients was conducted to determine adherence to pharmacotherapy of CHD with comorbid conditions using the standardized Medication Adherence Report Scale (MARS-5) scale. Nonparametric statistical methods were used, Spearman correlation analysis, ordinal logistic regression, and prediction to establish associations and determine the impact between pDDIs present in pharmacotherapy of CHD with comorbid conditions in prescriptions for pharmacological synergism, antagonism, and toxic effects due to pDDIs on adherence to treatment. Retrospective, clinical-epidemiological, frequency, content analyses, comparisons, and generalizations were used. Results: Unacceptable polypharmacy was identified in 95.86% of cases within the studied cohort. A strong positive correlation was noted between the number of pDDIs and pharmacodynamic synergism Conclusion: Pharmacological pDDIs due to pharmacodynamic antagonism (OR ~ 1.74) and toxic effects resulting from pDDIs (OR ~ 1.36) significantly increase the risk of low adherence to treatment. The identified risks can be minimized by implementing a multidisciplinary approach to providing medical care and involving clinical pharmacists in the quality control of complex prescription regimens and in optimizing pharmacotherapy of CHD with comorbid conditions.
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