Quantifying the Clinical Significance of Drug—Drug Interactions: Scaling Pharmacists' Perceptions of a Common Interaction Classification Scheme

OBJECTIVE: To develop a precise, interval level scale of the clinical significance of drug—drug interactions that reflects the professional judgments of practicing pharmacists. PARTICIPANTS: A convenience sample of 63 practicing pharmacists representing hospital (clinical and staff) and retail (chain and independent) practice settings. METHOD: Pharmacists judged the similarity among 15 interaction categories that have been commonly used to classify drug—drug interactions. A multidimensional scaling technique produced a spatial representation (i.e., a psychological map) of the structure inherent in those similarity judgments. Pharmacists' ratings of clinical significance were projected onto that same spatial representation using a multiple regression procedure, and the resulting information was used to develop a scale of clinical significance. RESULTS: The clinical significance scale developed from pharmacists' judgments was substantially different from a comparison scale published in a popular reference. The new scale was more precise than the comparison scale, and it also approximated an interval level of measurement. The judgments used to produce the new clinical significance scale were not reliably influenced by pertinent demographic characteristics of the sample. CONCLUSIONS: Inconsistencies between published clinical significance scales and the professional judgments of practitioners could affect patient care to the degree that a summary measure of clinical significance affects a practitioner's response to a potential drug—drug interaction. The clinical significance scale developed in this study has good measurement characteristics and reflects the professional judgments of practicing pharmacists. Use of the new scale is recommended on these grounds, although further assessment of its generality is warranted.

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856 CLINICAL SIGNIFICANCE OF DRUG–DRUG-INTERACTIONS IN THE ERA OF DIRECT ACTING ANTIVIRAL AGENTS AGAINST HEPATITIS C – A REAL-WORLD EXPERIENCE

Journal of Hepatology ◽

10.1016/s0168-8278(13)60858-2 ◽

2013 ◽

Vol 58 ◽

pp. S351

Author(s):

B. Maasoumy ◽

K. Port ◽

A.A. Markova ◽

B. Calle Serrano ◽

L. Sollik ◽

...

Keyword(s):

Hepatitis C ◽

Drug Interactions ◽

Clinical Significance ◽

Real World ◽

Antiviral Agents ◽

Direct Acting Antiviral ◽

Direct Acting ◽

Direct Acting Antiviral Agents

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Hierarchy of evidence in interpretation of clinical significance of drug interactions

Medicinski pregled ◽

10.2298/mpns1202045n ◽

2012 ◽

Vol 65 (1-2) ◽

pp. 45-49

Author(s):

Bozana Nikolic ◽

Miroslav Savic

Keyword(s):

Drug Metabolism ◽

Drug Interactions ◽

Clinical Significance ◽

Health Professionals ◽

Molecular Entity ◽

Population Pharmacokinetic ◽

Pharmacokinetic Studies ◽

Potential Interactions

Introduction. Since drug interactions may result in serious adverse effects or failure of therapy, it is of huge importance that health professionals base their decisions about drug prescription, dispensing and administration on reliable research evidence, taking into account the hierarchy of data sources for evaluation. Clinical Significance of Potential Interactions - Information Sources. The sources of data regarding drug interactions are numerous, beginning with various drug reference books. However, they are far from uniformity in the way of choosing and presenting putative clinically relevant interactions. Clinical Significance of Potential Interactions - Interpretation of Information. The difficulties in interpretation of drug interactions are illustrated through the analysis of a published example involving assessment made by two different groups of health professionals. Systematic Evaluation of Drug-Drug Interaction. The potential for interactions is mainly investigated before marketing a drug. Generally, the in vitro, followed by in vivo studies are to be performed. The major metabolic pathways involved in the metabolism of a new molecular entity, as well as the potential of induction of human enzymes involved in drug metabolism are to be examined. In the field of interaction research it is possible to make use of the population pharmacokinetic studies as well as of the pharmacodynamic assessment, and also the postregistration monitoring of the reported adverse reactions and other literature data. Conclusion. In vitro and in vivo drug metabolism and transport studies should be conducted to elucidate the mechanisms and potential for drug-drug interactions. The assessment of their clinical significance should be based on well-defined and validated exposure-response data.

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The clinical significance of drug-drug interactions in the era of direct-acting anti-viral agents against chronic hepatitis C

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.12523 ◽

2013 ◽

Vol 38 (11-12) ◽

pp. 1365-1372 ◽

Cited By ~ 25

Author(s):

B. Maasoumy ◽

K. Port ◽

B. Calle Serrano ◽

A. A. Markova ◽

L. Sollik ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Drug Interactions ◽

Chronic Hepatitis C ◽

Clinical Significance ◽

Direct Acting

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Potential drug-drug interactions in the psychiatric hospital: Frequency analysis

Research Results in Pharmacology ◽

10.3897/rrpharmacology.5.39681 ◽

2019 ◽

Vol 5 (4) ◽

pp. 1-6

Author(s):

Oleg O. Kirilochev ◽

Inna P. Dorfman ◽

Adelya R. Umerova ◽

Svetlana E. Bataeva

Keyword(s):

Drug Interactions ◽

Clinical Significance ◽

Psychiatric Hospital ◽

Psychiatric Inpatient ◽

Clinical Problem ◽

Drug Combinations ◽

Drug Prescriptions ◽

Inpatient Setting ◽

Potential Drug ◽

Important Clinical Problem

Introduction: Drug-drug interactions are an important clinical problem in pharmacotherapy. This study is focused on different types of drugs used in a psychiatric hospital. Materials and methods: The pharmacoepidemiological study included the analysis of medical records of 500 psychiatric inpatients. The patients were divided into 2 groups: under 65 and over 65 years of age. All the drug prescriptions were analyzed to identify the combinations of drugs that can induce drug-drug interactions and determine their clinical significance. Results and discussion: Over 77% of hospitalized patients were administered drug combinations that could induce drug-drug interactions, most of which were of moderate clinical significance. A reliable association was found between the patient’s age, the clinical significance of drug-drug interactions, and the pharmacotherapy structure. The most common irrational drug combinations were identified. Conclusion: Timely analysis of drug prescriptions for potential drug-drug interactions can enhance the safety of pharmacotherapy and decrease the risk of adverse drug reactions in the psychiatric inpatient setting.

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Development and Validation of an Environmental Health Literacy Assessment Screening Tool for Domestic Well Owners: The Water Environmental Literacy Level Scale (WELLS)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050881 ◽

2019 ◽

Vol 16 (5) ◽

pp. 881

Author(s):

Veronica Irvin ◽

Diana Rohlman ◽

Amelia Vaughan ◽

Rebecca Amantia ◽

Claire Berlin ◽

...

Keyword(s):

Health Literacy ◽

Construct Validity ◽

Environmental Health ◽

Screening Tool ◽

Environmental Literacy ◽

Convenience Sample ◽

Environmental Health Literacy ◽

Literacy Level ◽

Level Scale ◽

Kappa Agreement

In the U.S., privately owned wells are not subject to any regulatory testing requirements. Well owners must have sufficient environmental health literacy (EHL) to understand and interpret information that contain complex terms and labels to manage their water quality. The objective of this paper is to assess the performance and validity of a new EHL screening tool. The Water Environmental Literacy Level Scale (WELLS) is based on the Newest Vital Sign (NVS) and contains six questions on comprehension, calculations and application of information. Content validity was assessed from expert review. Criterion-related and construct validity were evaluated using an online, convenience sample of adults (n = 869). Percent of correct responses for items ranged from 53% to 96% for NVS and from 41% to 97% for WELLS. Completion time, mean scores, distributions, and internal consistency were equivalent between both scales. Higher scores suggest higher EHL. The scales were moderately correlated (ρ = 0.47, p < 0.001). Kappa agreement was 74%. Bland-Altman plots depicted little mean difference between the scales. Education and income level were positively associated with EHL. WELLS showed criterion-validity with NVS and construct validity with education and income. In practice or research, WELLS could quickly screen individuals for low EHL.

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