Evaluation of drug–drug interaction screening software combined with pharmacist intervention

Introduction Patients with cancer are increasingly using herbal supplements, unaware that supplements can interact with oncology treatment. Herb–drug interaction management is critical to ensure optimal treatment outcomes. Several screening tools exist to detect drug–drug interactions, but their performance to detect herb–drug interactions is not known. This study compared the performance of eight drug–drug interaction screening tools to detect herb–drug interaction with anti-cancer agents. Methods The herb–drug interaction detection performance of four subscription (Micromedex, Lexicomp, PEPID, Facts & Comparisons) and free (Drugs.com, Medscape, WebMD, RxList) drug–drug interaction tools was assessed. Clinical relevance of each herb–drug interaction was determined using Natural Medicine and each drug–drug interaction tool. Descriptive statistics were used to calculate sensitivity, specificity, positive predictive value, and negative predictive value. Linear regression was used to compare performance between subscription and free tools. Results All tools had poor sensitivity (<0.20) for detecting herb–drug interaction. Lexicomp had the highest positive predictive value (0.98) and best overall performance score (0.54), while Medscape was the best performing free tool (0.52). The worst subscription tools were as good as or better than the best free tools, and as a group subscription tools outperformed free tools on all metrics. Using an average subscription tool would detect one additional herb–drug interaction for every 10 herb–drug interactions screened by a free tool. Conclusion Lexicomp is the best available tool for screening herb–drug interaction, and Medscape is the best free alternative; however, the sensitivity and performance for detecting herb–drug interaction was far lower than for drug–drug interactions, and overall quite poor. Further research is needed to improve herb–drug interaction screening performance.

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An Assessment of Free, Online Drug-Drug Interaction Screening Programs (DSPs)

Hospital Pharmacy ◽

10.1177/001857870303800715 ◽

2003 ◽

Vol 38 (7) ◽

pp. 662-668 ◽

Cited By ~ 5

Author(s):

Minh V. Lam ◽

Gary M. Mccart ◽

Candy Tsourounis

Keyword(s):

Drug Interaction ◽

Data Bank ◽

Ease Of Use ◽

Cd Rom ◽

Survey Tool ◽

Screening Programs ◽

Comprehensive Search ◽

Interaction Screening ◽

Drug Drug Interaction ◽

Interaction Management

Objective This study evaluated the content and usability of four free, online drug-drug interaction screening programs (DSPs) and one proprietary DSP (CD-ROM format) requiring an annual fee. Methods Free, online DSPs that obtain their drug interaction information from unique providers were located through a comprehensive search of the Internet. For comparison purposes, a well-established, fee-based DSP was also included in the study. A tool for evaluating the DSPs for usability and quality of content was created. The usability characteristics assessed included ease of use, ability to support more than two drug entries at the same time, speed, and multifunctionality. Evaluation of content was based on accuracy, completeness, references, drug interaction management, and readability. A five-member panel of clinical pharmacists and drug information specialists in academia and the pharmaceutical industry validated the survey tool. Results Based on overall usability, Drkoop.com (Multum) rated higher than the other free DSPs, but below the comparator, DrugReax (Micromedex). Walgreens.com (Medi-Span) and Medscape (First Data-Bank) ranked lowest among all the DSPs in terms of usability. Based on content, Walgreens ranked first and Clinical Pharmacology 2000 (Gold Standard Multimedia) ranked last (P= 0.015, ANOVA). Conclusion All of the evaluated DSPs were useful. Some were better than others depending on the assessment category. Walgreens rated the highest in terms of accuracy, completeness, and drug interaction management information. Drkoop.com rated the highest with regard to comprehensive references and pharmacist-assessed, consumer-friendly language. All of the free, online DSPs could improve their speed of information retrieval.

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