Association between drug interactions and disease severity in patients with chronic obstructive pulmonary disease at dr. M. Djamil General Hospital, Padang
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Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease that frequently requires multiple medications due to disease complexity and comorbidities, increasing the risk of potential drug–drug interactions (DDIs). Previous studies have described potential DDIs and their risk factors in patients with COPD; however, evidence regarding their association with disease severity remains limited, particularly among hospitalized patients in Indonesia. Objective: This study aimed to determine the association between potential DDIs and disease severity among hospitalized patients with COPD at Dr. M. Djamil General Hospital, Padang. Methods: A quantitative observational study with a cross-sectional design was conducted prospectively among hospitalized patients with COPD from February to April 2026. Total sampling was applied, resulting in 25 eligible patients. Potential DDIs were identified using the Lexicomp® Drug Interactions database and classified according to severity and mechanism. Descriptive statistics were used to summarize patient characteristics and potential DDIs, while Fisher's Exact test was performed to analyze the association between potential DDIs and disease severity at a significance level of p < 0.05. Results: Most patients were male (76.0%), aged ≥60 years (56.0%), and received ≥10 medications (76.0%). Most were classified as GOLD II (72.0%). Potential DDIs were identified in 24 patients (96.0%), comprising 185 interaction events. Moderate interactions predominated (74.05%), followed by major (17.84%) and minor (8.11%) interactions. Pharmacodynamic interactions accounted for 93.51%, while pharmacokinetic interactions accounted for 6.49%. Potential DDIs occurred in all patients with GOLD II and GOLD III disease but not in the single GOLD I patient. Fisher's Exact test showed a significant association between potential DDIs and disease severity (p = 0.040). Conclusion: Potential DDIs were highly prevalent and predominantly moderate and pharmacodynamic. Their association with COPD severity highlights the need for routine medication review and closer monitoring, particularly in patients with moderate and severe COPD.
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