scholarly journals Evaluation of resources for analyzing drug interactions

2017 ◽  
Vol 104 (4) ◽  
Author(s):  
Risha I. Patel, PharmD ◽  
Robert D. Beckett, PharmD, BCPS

Objective: The research sought to evaluate seven drug information resources, specifically designed for analyzing drug interactions for scope, completeness, and ease of use, and determine the consistency of content among the seven resources.Methods: A cross-sectional study was conducted where 100 drug-drug and drug-dietary supplement interactions were analyzed using 7 drug information resources: Lexicomp Interactions module, Micromedex Drug Interactions, Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Stockley’s Drug Interactions (10th edition), Drug Interactions Analysis and Management (2014), and Drug Interaction Facts (2015). The interaction sample was developed based on published resources and peer input. Two independent reviewers gathered data for each interaction from each of the 7 resources using a common form.Results: Eighty-two drug-drug and 18 drug-dietary supplement interactions were analyzed. Scope scores were higher for Lexicomp Interactions (97.0%), Clinical Pharmacology Drug Interaction Report (97.0%), and Micromedex Drug Interactions (93.0%) compared to all other resources (p<0.05 for each comparison). Overall completeness scores were higher for Micromedex Drug Interactions (median 5, interquartile range [IQR] 4 to 5) compared to all other resources (p<0.01 for each comparison) and were higher for Lexicomp Interactions (median 4, IQR 4 to 5), Facts & Comparisons eAnswers (median 4, IQR 4 to 5), and Drug Interaction Facts (4, IQR 4 to 5) compared to all other resources, except Micromedex (p<0.05 for each comparison). Ease of use, in terms of time to locate information and time to gather information, was similar among resources. Consistency score was higher for Micromedex (69.9%) compared to all other resources (p<0.05 for each comparison).Conclusions: Clinical Pharmacology Drug Interaction Report, Lexicomp Interactions, and Micromedex Drug Interactions scored highest in scope. Micromedex Drug Interactions and Lexicomp Interactions scored highest in completeness. Consistency scores were overall low, but Micromedex Drug Interactions was the highest.

Author(s):  
Robert D. Beckett ◽  
Curtis D. Stump ◽  
Megan A. Dyer

Objective: The research evaluated point-of-care drug interaction resources for scope, completeness, and consistency in drug-ethanol and drug-tobacco content.Methods: In a cross-sectional analysis, 2 independent reviewers extracted data for 108 clinically relevant interactions using 7 drug information resources (Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Lexicomp Interactions, Micromedex Drug Interactions, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions). Scope (presence of an entry), completeness (content describing mechanism, clinical effects, severity, level of certainty, and course of action for each present interaction; up to 1 point per assessed item for a total possible score of 5 points), and consistency (similarity among resources) were evaluated.Results: Fifty-three drug-ethanol and 55 drug-tobacco interactions were analyzed. Drug-ethanol interaction entries were most commonly present in Lexicomp (84.9%), Clinical Pharmacology (83.0%), and Stockley’s Drug Interactions (73.6%), compared to other resources (p<0.05). Drug-tobacco interactions were more often covered in Micromedex (56.4%), Stockley’s Drug Interactions (56.4%), Drug Interaction Facts (43.6%), and Clinical Pharmacology (41.8%) (p<0.001). Overall completeness scores were higher for Lexicomp, Micromedex, Drug Interaction Facts, and Facts & Comparisons (median 5/5 points, interquartile range [IQR] 5 to 5, p<0.001) for drug-ethanol and for Micromedex (median 5/5 points, IQR 5 to 5, p<0.05) for drug-tobacco, compared to other resources. Drug Interaction Facts and Micromedex were among the highest scoring resources for both drug-ethanol (73.7%, 68.6%) and drug-tobacco (75.0%, 32.3%) consistency.Conclusions: Scope and completeness were high for drug-ethanol interactions, but low for drug-tobacco interactions. Consistency was highly variable across both interaction types.


Pharmacology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Bernardino Roca ◽  
Manuel Roca

<b><i>Introduction:</i></b> Multi-pathological patients are at high risk of drug interactions and side effects. We aimed to assess the usefulness of 3 online drug interaction checkers. <b><i>Methods:</i></b> In a cross-sectional study, carried out in the Medicine Department of Hospital General of Castellon, Spain, in February 2020, we assessed drug interaction detection with 3 online electronic checkers, Drugs.com, Lexicomp®, and Medscape, and compared results obtained with the 3 tools. From every hospitalized patient, we obtained the list of drugs he or she had been taking until admission. Bivariable tests were used for analysis. <i>p</i> values &#x3c;0.05 were considered significant. <b><i>Results:</i></b> We included data from 134 patients; 68 (51%) were male; median (and interquartile range) of their age was 82 (76–88) years. A total of 1,082 substance drugs were entered in the checkers. The number of highest grade interactions found with every program was Drugs.com 85, Lexicomp® 33, and Medscape 67. Positive correlations were found between age and number of drug substances prescribed (<i>p</i> = 0.009) and between number of drug substances prescribed and interactions found with any of the 3 checkers (<i>p</i> &#x3c; 0.001 in all 3 cases). Regarding highest grade interactions, agreement among all 3 checkers was poor. <b><i>Conclusions:</i></b> The 3 online checkers we assessed found a large number of interactions. The 3 programs gave very discrepant results. <b><i>Impact on Practice Statements:</i></b> The analyzed programs, Drugs.com, Lexicomp®, and Medscape Interactions, found a large number of drug interactions in the studied patients. The 3 programs gave very discrepant results among them.


2021 ◽  
Vol 59 (243) ◽  
pp. 1125-1130
Author(s):  
Lujaw Ratna Tuladhar ◽  
Shirish Lal Shrestha ◽  
Sneha Bimali ◽  
Srijana Bhusal ◽  
Pingala Khadka

Introduction: Drug-drug interaction is one of the causes of adverse drug reactions. Generally, drug-drug interaction is common in multidrug therapy. Diabetic patients, particularly due to associated comorbidities tend to have various drug-drug interactions due to the effect of multiple drugs. The objective of this study was to find out the prevalence of drug-drug interactions in diabetic patients. Methods: It was a descriptive cross-sectional study that was conducted among previously diagnosed diabetic patients visiting the outpatient department of medicine at a tertiary care hospital between March 2021 and August 2021. Ethical approval was taken from the institutional review committee (Ref no: 030-076/077). Data was collected from diabetic patients presenting to the outpatient department of medicine using a preformed self-constructed questionnaire. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of drug-drug interaction between hypoglycemic and non-hypoglycemic medication was 56 (44.1%) (35.5-52.7 at 95% Confidence Interval) of the patients out of which at least one drug-drug interaction was seen in 48 (37.8%) of the patients. Conclusions: Our study showed the prevalence of drug-drug interactions in diabetic patients to be higher than other studies done in similar settings. Based on the severity, we observed two types of drug-drug interactions; close monitoring drug-drug interactions and minor drug-drug interactions.


2019 ◽  
Vol 65 (5) ◽  
pp. 611-617
Author(s):  
Camila Ribeiro de Arruda Monteiro ◽  
Jean Henri Maselli Schoueri ◽  
Debora Terra Cardial ◽  
Lívia de Castro Linhares ◽  
Karine Corcione Turke ◽  
...  

SUMMARY INTRODUCTION: Drug interaction is an important cause of global morbidity. It is of particular importance in cancer patients since they are often in use of polypharmacy, related to interactions between the drugs and the chemotherapeutics used. OBJECTIVE: To evaluate the drug interaction between chemotherapy and other drugs in cancer patients. METHODS: a cross-sectional study carried out in the outpatient oncology department of a public tertiary hospital. Two hundred thirty-five patients were included, and the drugs they were using were identified. Using the MedScape and Epocrates database, we evaluated the interactions between medications and chemotherapy by defining their frequency and dividing their severity from interaction into mild, close monitoring necessity and severe. RESULTS: 161 patients had some drug interaction. We identified 9 types of mild interactions, 23 types of interactions with close monitoring necessity, and 2 types of serious interactions. The most frequent interactions were between fluorouracil and leucovorin (32 cases) and cyclophosphamide and doxorubicin (19 cases). Serious interactions were between aspirin and pemetrexed; and leucovorin and Bactrim. CONCLUSION: In the present study, drug interactions were frequent, including serious interactions with a potential increase in morbidity and mortality. Thus, it is necessary for oncologists to draw up a therapeutic plan considering potential interactions between prescribed chemotherapy and current medications in use by patients.


2018 ◽  
Vol 23 ◽  
pp. 2515690X1876484
Author(s):  
Ashley E. Montgomery ◽  
Robert D. Beckett ◽  
Kaitlin J. Montagano ◽  
Samah Kutom

Objective. To evaluate 6 tertiary, point-of-care drug information resources’ dietary supplement content. Methods. This was a cross-sectional evaluation of Lexicomp Natural Products Database, Micromedex Alternative Medicine, Clinical Pharmacology, Natural Medicines, The Review of Natural Products, and Handbook of Nonprescription Drugs. Each resource was evaluated for scope, completeness, consistency, and ease of use. Results. For a sample of 66 supplements, scope scores ranged from 69.7% (Micromedex) to 100% (Natural Medicines). Completeness scores were high considering uses, dose, adverse effects, and mechanism (85.7% to 100%). Overall completeness scores ranged from 82.5% ( Handbook of Nonprescription Drugs) to 100% (Clinical Pharmacology, Natural Medicines, The Review of Natural Products). Consistency scores ranged from 0% ( Handbook of Nonprescription Drugs) to 100% (Natural Medicines, The Review of Natural Products). Mean time to locate and gather information was similar among groups. Conclusions. Resources were similar for completeness and ease of use. Scope and consistency varied depending on the resource.


Author(s):  
Sujeet A. Divhare ◽  
Satyashil Ingale

Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction. Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital. Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward. Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P <0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; <35 years-37%). Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit. Keywords: diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy


2019 ◽  
Vol 23 ◽  
Author(s):  
Ana Laura Biral Cortes ◽  
Zenith Rosa Silvino ◽  
Fernanda Barbosa Moreira Santos ◽  
Juliana Aguiar Carvalho Pereira ◽  
Graziela Silva Tavares

2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.


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