Analysis of drug-food interactions in inpatient treatment: A university hospital case

Abstract

Patients' nutrition during inpatient treatment can reduce the pharmacodynamics of drugs. Therefore, monitoring of drug-nutrient interactions is essential for patient safety. Pharmaceutical Data Banks (PDB) databases provide information regarding potential drug-drug, drug-food, and drug-allergy interactions. When Clinical Decision Support Systems (CDSS) are integrated with PDBs, drug-drug and drug-allergy interactions can be prevented when physicians prescribe drugs and when pharmacists evaluate those prescriptions. However, nutrition planning is done by dieticians, and it is not common practice for dieticians to use CDSSs integrated with PDB to access patient prescription information. This study aims to measure drug-food interactions in hospitals where physicians and pharmacists use CDSSs integrated with PDBs. For the most part, dieticians plan patient diets according to the patient's primary disease (diabetes, etc.) and do not access prescription data. We cooperated with a university hospital in Turkey, accredited by HIMSS in 2017 at EMRAM Stage 6, to monitor hospitalized patients for at least one week in 2018. According to the findings, it was determined that 1,451 different drugs were administered 1,620,573 times to a total of 27,455 patients. It was determined that eight (0.55%) different drugs administered to 581 (2.1%) of the patients could interact with food and that these eight drugs were prescribed 8,089 times (0.49%) during the observation period. Although some drug-nutrient interactions were documented due to the study, the number of detected and documented interactions and their severity were relatively low. Precautions taken by dieticians, such as completely removing certain nutrients, like grapefruit, from the diet list, seem to be effective in preventing common interactions. To eliminate drug-nutrient interactions, it will be beneficial for dieticians to access patients' prescribing information and use the CDSS integrated with PDB.