Abstract
The characterization of drug-drug interactions (DDIs) may require the use of several different tools, such as the thesaurus issued by our national health agency (i.e., ANSM), the metabolic pathways table from the Geneva University Hospital (GUH), and DDI-Predictor (DDI-P). We sought to (i) compare the three tools’ respective abilities to detect DDIs in routine clinical practice and (ii) measure the pharmacist intervention rate (PIR) and physician acceptance rate (PAR) associated with the use of DDI-P. The three tools’ respective DDI detection rates (in %) were measured. The PIRs and PARs were compared by using the area under the curve ratio given by DDI-P (RAUC) and applying a chi-squared test. The DDI detection rates differed significantly: 40.0%, 76.5%, and 85.2% for ANSM (The National Agency for the Safety of Medicines and Health Products), GUH and DDI-P, respectively (p < 0.0001). The PIR differed significantly according to the DDI-P’s RAUC: 90.0%, 44.2% and 75.0% for RAUC ≤ 0.5; RAUC 0.5–2 and RAUC > 2, respectively (p < 0.001). The overall PAR was 85.1% and did not appear to depend on the RAUC category (p = 0.729). Our results showed that more pharmacist interventions were issued when details of the strength of the DDI were available. The three tools can be used in a complementary manner, with a view to refining medication adjustments.
Highlights
Drug error is a major concern for inpatients and outpatients
The RAUC is quoted as the mean ± standard deviation
The data given to pharmacists by several databases are rarely accurate enough to allow drug therapy to be safely modified in cases of a drug-drug interactions (DDIs), cirrhosis, or the presence of gene polymorphism
Summary
Drug error is a major concern for inpatients and outpatients. It has been reported that serious adverse drug reactions were responsible for 6.5% of all admissions to two large general hospitals in the UK [1]. Two French studies [2,3] showed that drugs were responsible for almost 0.7‰ of serious adverse events and accounted for 4.5% of all hospital admissions [2,3]. To reduce the risk of adverse drug reactions, prescribing physicians must take account of several variables: compliance with the indication, the regimen, possible comorbidities (e.g., renal, hepatic or cardiac failure, individual metabolic particularity) associated with pharmacokinetic changes, and potential drug-drug interactions (DDIs) [4]. Pharmacokinetic changes are difficult to quantify but can occur at different stages in the ADME process.
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