Drug-drug interaction software in clinical practice: a systematic review

Roblek, Tina; Vaupotič, Tomaž; Mrhar, Aleš; Lainščak, Mitja

doi:10.1007/s00228-014-1786-7

Cited by 141 publications

(104 citation statements)

References 53 publications

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“…Numerous online drugdrug interaction databases (DIDs) are available as open access or subscription resource [4][5][6][7]. Unfortunately, these often provide little consensus, if not even contradictory advice, much to the frustration of the health-care provider [4,5,[7][8][9]. Studies comparing DIDs have found substantial variations in severity classification and in the availability of underlying references and accessed knowledge resources [4][5][6][7][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…It is impossible for health-care professionals to recognize or hold at hand knowledge on all potentially clinically relevant DDIs, and clinical support systems on drug-drug interactions have become widely available to health-care professionals worldwide. Numerous online drugdrug interaction databases (DIDs) are available as open access or subscription resource [4][5][6][7]. Unfortunately, these often provide little consensus, if not even contradictory advice, much to the frustration of the health-care provider [4,5,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Drug interaction databases in medical literature: transparency of ownership, funding, classification algorithms, level of documentation, and staff qualifications. A systematic review

Kongsholm

Nielsen

Damkier

2015

Eur J Clin Pharmacol

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Drug interaction databases in medical literature: transparency of ownership, funding, classification algorithms, level of documentation, and staff qualifications. A systematic review

Kongsholm

Nielsen

Damkier

2015

Eur J Clin Pharmacol

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“…24 LexiInteract showed high sensitivity (87%-100%) and specificity (80%-90%) according to the studies which have evaluated the performance of the DDI screening software. [25][26][27] The 24 hour interval between administrating two drugs was used for assessing pDDI prevalence. According to the LexiInteract database pDDIs of classes A (no interaction) and B (no action needed) are of academic, but not a relevant clinical concern.…”

mentioning

confidence: 99%

The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study

Kovačević

Miljković

et al. 2017

Int J Clin Pract

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SummaryAim: The aim was to describe the type and prevalence of potentially relevant drugdrug interactions (pDDIs) in a population of patients admitted for cardiovascular diseases (CVD), and management strategies for reducing the occurrence of pDDIs. Methods:A retrospective cross-sectional study was performed on Cardiology ward of University Clinical Hospital Center in Belgrade, Serbia. A total of 527 patients, with more than one prescription during hospital stay, were enrolled in this study. Data were obtained from medical records. LexiInteract was used as the screening tool.Results: At least one potentially relevant pDDI was identified in 83.9% of patients.Occurrence was significantly more prevalent in patients with higher number of drugs, multimorbidity, longer length of stay, arrhythmia, heart failure, infectious and respiratory disease. About 13% of pDDIs exposures were accompanied with concurrent renal or liver disease, as an additional risk for DDI manifestation. Among CVD, patients with a history of myocardial infarction possessed the highest additional risk. The most common potential clinical outcome was the effect on cardiovascular system 48.5%, renal function and/or potassium 22.3%, bleeding 9.5%, impaired glucose control 6.8% and digoxin toxicity 4.6%. Main management strategies to avoid X or D class included using paracetamol instead of NSAID or alternative NSAID (38%), alternative antibiotic or antifungal (20.4%), H 2 receptor antagonist instead of PPI (8.3%), avoiding therapeutic duplication (7.3%), and alternative HMG-CoA reductase inhibitor (7%). Heart rate, blood pressure, electrolytes/potassium and blood glucose could have been employed in monitoring for potential consequence of 72.2% C class pDDIs. Conclusions:Use of drug interaction screening tools can be beneficial risk mitigation strategy for potentially relevant pDDIs in CVD patients. DDI screening software could be linked to the patient's laboratory results or clinical data regarding renal or liver function, as an approach to reinforce DDIs alert quality.

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“…(25) Even very simple systems can be helpful, and it generally holds true that physicians with training in geriatrics are less likely to prescribe potentially inappropriate medications. (26,27) These issues need to be given first line priority by the decision makers to allow adequate development of geriatric medicine at all levels of a health care system. The general scheme of old patient management is shown in the figure (Fig 1).…”

Section: Management After Icu Dis-chargementioning

confidence: 99%

Geriatric patients in the ICU

Voga¹

2017

Signa Vitae

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The proportion of patients older than 80 years admitted to the ICU is constantly increasing. Despite well-known admission criteria, older patients are frequently not referred and are admitted to the ICU. The emergency ward and ICU management of acute medical conditions should not depend on age only, but should be tailored to the individual patient in line with standards of care. After the successful treatment of acute illness, elderly people should receive complex and prolonged physical, social and psychological rehabilitation. Nevertheless, we must be able to recognize the point of futile treatment and provide proper palliative care. Less traumatised procedures that are better tolerated are preferred in the management of specific medical conditions in geriatric patients. General preventive programs promoting healthy lifestyles have been developed, but these must be implemented by a majority of older people. Medical science should promote adequate education of all professionals who are involved in the treatment of geriatric patients; societies should provide equal access to health-care in developed countries and countries in transition.

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Drug-drug interaction software in clinical practice: a systematic review

Abstract: The deficiency of clinical relevance of detected DDIs should be addressed in the upcoming research as it would provide more relevant information to the prescribers' in clinical practice.

Cited by 141 publications

References 53 publications

Drug interaction databases in medical literature: transparency of ownership, funding, classification algorithms, level of documentation, and staff qualifications. A systematic review

Drug interaction databases in medical literature: transparency of ownership, funding, classification algorithms, level of documentation, and staff qualifications. A systematic review

The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study

Geriatric patients in the ICU

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