Author/Editor     Muhič, Neža; Mrhar, Aleš; Brvar, Miran
Title     Comparative analysis of three drug-drug interaction screening systems against probable clinically relevant drug-drug interactions
Type     članek
Vol. and No.     Letnik 73, št. 7
Publication year     2017
Volume     str. 875-882
ISSN     1432-1041 - European journal of clinical pharmacology
Language     eng
Abstract     Purpose Drug-drug interaction (DDI) screening systems report potential DDIs. This study aimed to find the prevalence of probable DDI-related adverse drug reactions (ADRs) and compare the clinical usefulness of different DDI screening systems to prevent or warn against these ADRs. Methods A prospective cohort study was conducted in patients urgently admitted to medical departments. Potential DDIs were checked using Complete Drug Interaction, Lexicomp Online, and Drug Interaction Checker. The study team identified the patients with probable clinically relevant DDI-related ADRs on admission, the causality of which was assessed using the Drug Interaction Probability Scale (DIPS). Sensitivity, specificity, and positive and negative predictive values of screening systems to prevent or warn against probable DDI-related ADRs were evaluated. Results Overall, 50 probable clinically relevant DDI-related ADRs were found in 37 out of 795 included patients taking at least two drugs, most common of them were bleeding, hyperkalemia, digitalis toxicity, and hypotension. Complete Drug Interaction showed the best sensitivity (0.76) for actual DDI-related ADRs, followed by Lexicomp Online (0.50), and Drug Interaction Checker (0.40). Complete Drug Interaction and Drug Interaction Checker had positive predictive values of 0.07; Lexicomp Online had 0.04. We found no difference in specificity and negative predictive values among these systems. Conclusion DDI screening systems differ significantly in their ability to detect probable clinically relevant DDI-related ADRs in terms of sensitivity and positive predictive value. Keywords Actual drug-drug interactionsPotential drug-drug interactionsAdverse drug reactions Drug-drug interaction screening systems
Keywords     actual drug-drug interactions
potential drug-drug interactions
adverse drug reactions
drug-drug interaction screening systems