Determinants of potential drug–drug interaction associated dispensing in community pharmacies in the Netherlands

Abstract

Objective: There are many drug-drug interactions (D-DI) of which some may cause severe adverse patient outcomes. Dispensing interacting drug combinations should be avoided when the risks are higher than the benefits. The objective of this study was to identify determinants of dispensing undesirable interacting drug combinations by community pharmacies in the Netherlands. Methods: A total of 256 Dutch community pharmacies were selected, based on the dispensing of 11 undesirable interacting drug combinations between January 1st, 2001 and October 31st, 2002. These pharmacies were sent a questionnaire by the Inspectorate for Health Care (IHC) concerning their process and structure characteristics. Main outcome measure: The number of times the 11 undesirable interacting drug combinations were dispensed.Results: Two hundred and forty-six questionnaires (response rate 96.1%) were completed. Dispensing determinants were only found for the D-DI between macrolide antibiotics and digoxin but not for the other 10 D-DIs. Pharmacies using different medication surveillance systems differed in the dispensing of this interacting drug combination, and pharmacies, which were part of a health care centre dispensed this interacting drug combination more often. Conclusion: Medication surveillance in Dutch community pharmacies seems to be effective. Although for most D-DIs no determinants were found, process and structure characteristics may have consequences for the dispensing of undesirable interacting drug combinations.

Effects of mental demands during dispensing on perceived medication safety and employee well-being: A study of workload in pediatric hospital pharmacies

“…Some of those studies show that pharmacists perceive workload to contribute to unwanted outcomes 8, 38, 43, 70 while others, as in this study, have tested the relationship between separate measures of workload and outcomes 27, 33, 43. We know of only one series of studies, however, that generally explored the effects of mental demands, task-specific demands, or a combination of the two,3, 23, 31, 63, 71, 72 and none in hospital pharmacies.…”

“…American Society of Health-System Pharmacists: “all activities related to providing pharmacy patient care services.”42 In contrast, measures of workload that describe the worker’s subjective experience of work demands, 4, 32, 33, 38, 43, 44 are less commonly used and less systematically applied 27, 30. This fact is unfortunate, because human factors specialists and other occupational researchers have made major advances in the theory and application of subjective workload measurement 45, 46.…”

Potential drug–drug interactions in prescriptions dispensed in community pharmacies in Greece

“…Although many DDIs exist, only a small part of these is clinically relevant [3][4][5]. Multiple drug treatment has been associated with the occurrence of DDIs, adverse drug reactions (ADRs), medication errors, and increased risk of hospitalization [6,7] with several studies suggest that DDIs may be the cause of up to 3% of all hospital admissions [8][9][10][11][12]. Usually when multiple drug treatment is unavoidable, the potential benefits of drug combinations are weighted against the risk of the occurrence of a clinically significant DDI, taking into account the availability of alternatives.…”

Frequency of potential interactions between drugs in medical prescriptions in a city in southern Brazil

“…2 As a rule, drug-drug interactions are the cause of about 3.8% of hospitalizations 3 and they may cause several adverse events in patients. 4 Drug interactions consist of several mechanisms, which may be classified (1) as pharmacokinetic mechanisms, when one drug interferes with the absorption, distribution, metabolism or excretion of another drug, or (2) as pharmacodynamic mechanisms, when drugs with similar effects are administered together with the occurrence of either synergism or opposition of their effects that reduces the reaction to one or both drugs. A third interaction classification may occur in vitro when one or both drugs are inactivated.…”