Hospital admissions/visits associated with drug–drug interactions: a systematic review and meta‐analysis

Dechanont, Supinya; Maphanta, Sirada; Butthum, Bodin; Kongkaew, Chuenjid

doi:10.1002/pds.3592

Cited by 244 publications

(203 citation statements)

References 49 publications

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“…17 The high prevalence of observed PDDI exposures does not correspond with reported rates of ADEs, which either occur or are recognized far less frequently. 2,8,18,19 At the same time, ADEs can result in significant morbidity and mortality. [20][21][22] Our findings therefore point to a central problem or tradeoff of warning systems, encapsulated by the story of the boy who cried wolf: the current compendiums of PDDIs suffer from identifying so many PDDIs that the signal of true potential patient harm may get lost in the noise of too many alarms.…”

Section: Figurementioning

confidence: 99%

“…4 The epidemiology of pediatric PDDIs, however, is largely unknown: we lack estimates of the prevalence of pediatric PDDIs, reliable knowledge regarding the risk posed by specific PDDIs (especially important given the countervailing risks posed by the condition under treatment), or an adequate understanding about pathways by which PDDIs may lead to harmful ADEs in pediatric patients (eg, as a direct physiologic effect on an organ system or through modulation of another medication's effect). [6][7][8] Each of these critical pieces of information is integral to developing and studying strategies to mitigate clinically important ADEs associated with specific PDDIs.…”

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confidence: 99%

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Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Feinstein

Dai²,

Zhong³

et al. 2015

Pediatrics

106

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Section: Figurementioning

confidence: 99%

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confidence: 99%

Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Feinstein

Dai²,

Zhong³

et al. 2015

Pediatrics

106

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show abstract

“…A recent meta-analysis of studies found that 22.2% of adverse drug event associated hospital admissions were attributable to drug-drug interactions (interquartile range 16.6 -36.0%) [1]. Ensuring that medication therapy occurs safely and to the maximum benefit of any given patient is of great interest to clinicians [2].…”

Section: Introductionmentioning

confidence: 99%

Identifying Common Methods Used by Drug Interaction Experts for Finding Evidence About Potential Drug-Drug Interactions: Web-Based Survey (Preprint)

Grizzle¹,

Horn²,

Collins³

et al. 2018

Preprint

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Background: Preventing drug interactions is an important goal to maximize patient benefit from medications. Summarizing potential drug-drug interactions (PDDIs) for clinical decision support is challenging and there is no single repository for PDDI evidence. Additionally, inconsistencies across compendia and other sources have been well-documented. Standard search strategies for complete and current evidence about PDDIs have not heretofore been developed or validated. Objective: The purpose of this study was to identify common methods for conducting PDDI literature searches used by experts who routinely evaluate such evidence. Methods: A convenience sample of 70 drug information experts, including compendia editors, knowledge base vendors, and clinicians were invited via email to complete a survey on identifying PDDI evidence. An online survey was created and included questions addressing: 1) development and conduct of searches; 2) resources used e.g., databases, compendia, search engines etc.; 3) types of keywords used to search for specific PDDI information; 4) study types included and excluded in searches; and 5) search terms used. Search strategy questions focused on six topics of PDDI information: 1) that a PDDI exists; 2) seriousness; 3) clinical consequences; 4) management options; 5) mechanism; and 6) health outcomes. Results: Twenty participants (response rate 29%) completed the survey. The majority (85%) were drug information specialists, drug interaction researchers, compendia editors, or clinical pharmacists with 60% having over ten years' experience. Over half (55%) worked for clinical solutions vendors or knowledge-base vendors. Most participants develop (90%) and conduct (95%) search strategies without librarian assistance. PubMed (100%) and Google Scholar (55%) are most commonly searched for articles, followed by Google Web Search (35%) and EMBASE (15%). No respondents reported using Scopus. A variety of subscription and open-access databases were used, most commonly Lexicomp (9/20; 45%), Micromedex (8/20; 40%), Drugs@FDA (17/20; 85%), and DailyMed (13/20; 65%). Facts and Comparisons was the most commonly used compendia (8/20; 40%). Across the 6 attributes of interest, generic drug name was the most common keyword used. Respondents reported using more types of keywords when searching to identify existence of PDDIs and determine their mechanism than for the other four attributes (seriousness, consequences, management, and health outcomes). With respect to types of evidence useful for evaluating a PDDI, clinical trials, case reports, and systematic reviews were considered relevant, while animal and in vitro data studies were not. Conclusions:The results suggest that drug information experts use various keyword strategies and various database and web resources depending on the PDDI evidence they are seeking to identify.

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“…Furthermore, the presence of DDIs in hospitalized patients is one of the major causes of adverse events [4,5]. In ambulatory patients, DDIs represent 0.1% of hospital visits and 1.1% of hospital admissions [6], resulting in increased hospital stay days, as well as higher costs D DAVID PUBLISHING associated with healthcare [7,8]. The risk factors associated with DDIs include age, the number of prescription medications, the presence of comorbidities and the number of hospital stay days [3,[9][10][11].…”

mentioning

confidence: 99%

Prevalence of Potential Drug-Drug Interactions in Hospitalized Surgical Patients

Sánchez-López¹,

Brennan-Bourdon²,

Rincón-Sánchez³

et al. 2016

JPP

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Abstract:The objective of this study is to estimate the prevalence and describe the characteristics of pDDIs (potential drug-drug interactions) in medical prescriptions of hospitalized surgical patients. In this cross-sectional study, we analyzed 370 medical prescriptions from the surgery unit of a Mexican public teaching hospital. The identification and classification of potential drug-drug interactions were performed with the Micromedex 2.0 electronic drug information database. Results were analyzed with descriptive statistics and we estimated OR (odds ratio) to determine associated risk factors. From the study, it was found that the prevalence of potential drug-drug interactions was 45.9%. A total of 385 interactions were identified. Of these, 54.3% were classified as major and 60.5% as pharmacodynamic. Prescriptions for more than seven drugs (OR =7.33, CI (confidence interval) = 4.59~11.71) and advanced age > 60 years, (OR = 1.79, CI = 1.06~2.74) were positively associated with the presence of potential drug-drug interactions. We found a high prevalence of clinically relevant pDDIs in the surgery unit. In view of this outcome, the safety of drug combinations in hospitalized surgical patients should be evaluated during the prescription process in order to prevent adverse events.

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Hospital admissions/visits associated with drug–drug interactions: a systematic review and meta‐analysis

Abstract: Drug-drug interactions are a significant cause of hospital admissions and hospital visits. Improved DDI information gathering could help to reduce such adverse effects from DDIs, especially for patients using non-steroidal anti-inflammatory drugs and warfarin.

Cited by 244 publications

References 49 publications

Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Identifying Common Methods Used by Drug Interaction Experts for Finding Evidence About Potential Drug-Drug Interactions: Web-Based Survey (Preprint)

Prevalence of Potential Drug-Drug Interactions in Hospitalized Surgical Patients

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