The value of software that provides clinically relevant information on drug interactions

Antoniazzi, Stefania; Chiarelli, Maria Teresa; Nobili, Alessandro; Pasina, Luca; Venturini, Francesca

doi:10.1016/j.ejim.2015.07.004

Cited by 8 publications

(9 citation statements)

References 6 publications

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“…Data were collected from the databases of three general practitioners from the city of Turin, Italy. INTERCheck® has also been validated for clinical practice confirming its effectiveness in reducing severe potential DDIs [11]. The program also provides the Beers criteria and the STOPP criteria related to the drugs present in the chronic therapy of the patient, highlighting the potentially inappropriate drugs and advised against the drugs to be used with caution.…”

Section: Methodsmentioning

confidence: 99%

Risk of drug interactions and prescription appropriateness in elderly patients

Petrini¹,

Caviglia

Pellicano

et al. 2019

Ir J Med Sci

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Background:In Europe, adverse drug reactions and drug interactions are cause of considerable morbidity and mortality. In over 75s, hospital access due to adverse drug reactions can be as high as 1 in every 3. Aims:To assess the quality of the prescribed polytherapies in the territory, in terms of the risk of drug interactions and of prescription appropriateness, in over 75s.Methods: Randomly selected patients, over 75s, were analysed among the patients of 3 general practitioners. Their data were analysed with the INTERCheck® software. This software provided the list of drug interactions deriving from the chronic therapies. The program also provided the Beers criteria and the STOPP criteria related to the drugs, highlighting potentially inappropriate drugs.Results: 188 patients were included in the study. 216 serious or very serious drug interactions have been identified. 92 patients (48.9%) were at risk of at least one serious or very serious interaction. The cut-off of the correlation between the number of drugs taken and the risk of incurring a serious or very serious interaction was found to be 5 (AUC = 0.833, sensitivity = 87%, p < 0.001). Patients on >= 4 drugs were at risk of prescriptive inappropriateness with a sensitivity of 84% (AUC = 0.781, p < 0.0001). Conclusions:Focusing on patients with at least 4 drugs in therapy is the right strategy to reduce the risks associated with polypharmacy.

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Section: Methodsmentioning

confidence: 99%

Risk of drug interactions and prescription appropriateness in elderly patients

Petrini¹,

Caviglia

Pellicano

et al. 2019

Ir J Med Sci

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“…19 Agreement between the clinical relevance of DDIs detected by INTERCheck and clinicians’ personal judgment was also found in a retrospective study conducted on medical records of elderly patients admitted to 4 medical wards of a large teaching hospital. 20 We excluded all potentially appropriate treatments from the analysis because the risks associated with these drugs are balanced by their potential benefits.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Preventive and Symptomatic Drug Treatments in Hospice Care: An Italian Observational Study

Pasina

Recchia²,

Agosti

et al. 2018

Am J Hosp Palliat Care

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Hospice admission can be associated with a definite reduction in the use of commonly prescribed preventive medications. However, about half of end-of-life patients can be prescribed avoidable medications. Drugs for peptic ulcer and gastroesophageal reflux disease and antithrombotics were the potentially avoidable preventive medications most frequently prescribed at admission to the hospice and before death.

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“…A computer-based application, such as INTERCheck ® , can be used to review medications in elderly patients, combining their clinical, cognitive and functional status evaluations with an analysis of adverse event risk and drug–drug interactions and improving prescribing quality. In a recent retrospective study, clinicians judged nearly 50% of pDDIs identified by INTERCheck ® in the medications on medical record as clinically relevant (because of their potential clinical impact in relation to comorbidity or because their impacts were unknown) [ 7 ]. In the presence of multimorbidity (i.e., two or more long-term health conditions), the UK National Institute for Health and Care Excellence suggested a tailored approach to care [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…After providing informed consent, every subject underwent a multidimensional assessment, including the Cumulative Illness Rating Scale, Charlson Comorbidity Index and Elixhauser Index; cognitive function was evaluated using the Mini-Mental State Examination (MMSE) [ 10 – 13 ]. The clinical evaluation included anthropometric measurements (body mass index and metabolic syndrome using Adult Treatment Panel III criteria), hemodynamic parameters (systolic and diastolic blood pressure, heart rate, electrocardiography with QTc interval measurements), blood chemistry tests with complete blood count, sodium, potassium, creatinine with estimation of glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation, albumin, glycaemia, vitamin D, pharmacological history (drug number and dosage), the Anticholinergic Cognitive Burden (ACB) scale (2012 update) [ 14 , 15 ] and drug–drug interaction risk analyzed using the INTERCheck ® software ( http://www.intercheckweb.it ) [ 7 ]. The information provided by INTERCheck ® includes drug interactions (database of interactions created and updated by the Mario Negri IRCCS Institute for Pharmacological Research); potentially inappropriate drugs in the elderly according to criteria from the scientific literature such as Beers and START (Screening Tool to Alert to Right Treatment)/STOPP (Screening Tool of Older Persons’ Prescriptions); evaluation of the anticholinergic load (ACB scale); GerontoNet adverse drug reaction risk score algorithm (for identifying patients at greater risk of unwanted drug effects).…”

Section: Methodsmentioning

confidence: 99%

“…The multiple negative outcomes of polypharmacy include cognitive impairment/delirium, weight loss and malnutrition, falls with hip fractures, urinary incontinence, functional impairment and reduced mobility, hospitalization, reduced quality of life, death and increased costs for the health system [5,6]. Computerized prescription support systems (CPSS) may help to prevent inappropriate medication, minimizing the occurrence of adverse drug events (ADEs) and subsequent negative outcomes [7].…”

Section: Introductionmentioning

confidence: 99%

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Using INTERCheck® to Evaluate the Incidence of Adverse Events and Drug–Drug Interactions in Out- and Inpatients Exposed to Polypharmacy

Martocchia

Spuntarelli

Aiello

et al. 2020

Drugs - Real World Outcomes

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Background Polypharmacy exposes patients with comorbidities (particularly elderly patients) to an increased risk of drug-specific adverse events and drug-drug interactions. These adverse events could be avoided with the use of a computerized prescription support system in the primary care setting. The INTERCheck ® software is a prescription support system developed with the aim of balancing the risks and benefits of polytherapy and examining drug-drug interactions. Objectives This observational study used the INTERCheck ® software to evaluate the incidence of adverse events and of drug-drug interactions in outpatients and inpatients receiving multiple medications. Methods Patients were randomly enrolled from the outpatient department (n = 98) and internal medicine ward (n = 46) of S. Andrea Hospital of Rome. Polypharmacological treatment was analyzed using INTERCheck ® software, and the prevalence of risk indicators and adverse events was compared between the two groups. Results Polypharmacy (use of five or more drugs) applied to all except three cases among outpatients and one case among inpatients. A significant positive correlation was found between the number of medications and the INTERCheck ® score (ρ = 0.67; p < 0.000001), and a significant negative correlation was found between the drugrelated anticholinergic burden and cognitive impairment (r = − 0.30 p = 0.01). Based on the INTERCheck ® analysis, inpatients had a higher score for class D (contraindicated drug combination should be avoided) than did outpatients (p = 0.01). The potential class D drug-drug interactions were associated with adverse events that caused hospitalization (χ 2 = 7.428, p = 0.01). Conclusions INTERCheck ® analysis indicated that inpatients had a high risk of drug-drug interactions and a high percentage of related adverse drug events. Further prospective studies are necessary to evaluate whether the INTERCheck ® software may help reduce polypharmacy-related adverse events when used in a primary care setting and thus potentially avoid related hospitalization and severe complications such as physical and cognitive decline.

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The value of software that provides clinically relevant information on drug interactions

Cited by 8 publications

References 6 publications

Risk of drug interactions and prescription appropriateness in elderly patients

Risk of drug interactions and prescription appropriateness in elderly patients

Prevalence of Preventive and Symptomatic Drug Treatments in Hospice Care: An Italian Observational Study

Using INTERCheck® to Evaluate the Incidence of Adverse Events and Drug–Drug Interactions in Out- and Inpatients Exposed to Polypharmacy

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