Analysis 3.2. Comparison 3 Prophylactic low molecular weight heparin (LMWH) versus placebo, Outcome 2 Venous thromboembolism 3-month follow-up..

Research of clinical guidelines (CG), computer decision support systems (CS), systematic reviews (SR) and original studies (January 2008 to May 2011). MeSH terms: venous thrombosis; heparin, low-molecular-weight; antiinflammatory agents. American Family Physician's Strength of Recommendation Taxonomy (SORT) was used to assess the level of evidence. Data sources: Pubmed database, evidence-based medicine websites, General Directorate of Health, Portuguese Association of General Practitioners, MGFamiliar.net, Index of Portuguese Medical Magazines.

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Background: Drug-disease interactions negatively affect the benefit/risk ratio of drugs for specific populations. In these conditions drugs should be avoided, adjusted, or accompanied by extra monitoring. The motivation for many drug-disease interactions in the Summary of Product Characteristics (SmPC) is sometimes insufficiently supported by (accessible) evidence. As a consequence the translation of SmPC to clinical practice may lead to non-specific recommendations. For the translation of this information to the real world, it is necessary to evaluate the available knowledge about drug-disease interactions, and to formulate specific recommendations for prescribers and pharmacists. The aim of this paper is to describe a standardized method how to develop practice recommendations for drug-disease interactions by literature review and expert opinion. Methods: The development of recommendations for drug-disease interactions will follow a six-step plan involving a multidisciplinary expert panel (1). The scope of the drug-disease interaction will be specified by defining the disease and by describing relevant effects of this drug-disease interaction. Drugs possibly involved in this drug-disease interaction are selected by checking the official product information, literature, and expert opinion (2). Evidence will be collected from the official product information, guidelines, handbooks, and primary literature (3). Study characteristics and outcomes will be evaluated and presented in standardized reports, including preliminary conclusions on the clinical relevance and practice recommendations (4). The multidisciplinary expert panel will discuss the reports and will either adopt or adjust the conclusions (5). Practice recommendations will be integrated in clinical decision support systems and

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