Determination of Potential Drug-Drug Interactions in General Pediatric Ward Patients: A Cross-Sectional Study

Abstract

Objective: This study seeks to identify potential drug-drug interactions (pDDIs) in hospitalized patients and compare two commercial drug interaction databases.
 Material and Method: This prospective cross-sectional study was conducted between February and May 2022 in a tertiary care hospital's general pediatric ward. UpToDate® and Micromedex® Drug Interaction databases were used to determine pDDIs.
 Result and Discussion: In total, 267 pDDIs were found in 51 pediatric patients' medication lists (181 via UpToDate® and 86 via Micromedex®). The use of at least five different systemic drugs concurrently was statistically significant between groups of patients who experienced at least one pDDI and those who did not. The binary logistic regression analysis showed that a one-drug increase in the total number of drugs a patient received during hospitalization increased the probability of pDDIs by 2.12-fold (CI: 1.321-3.417, p=0.002). The concordance rate between UpToDate® and Micromedex® databases for pDDI determination was 84.31% (kappa coefficient=0.676, standard error=0.102, (p ≤ 0.001)). When the UpToDate® database was assumed as a reference database, the Micromedex® database's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in determining pDDIs were 79.41%, 94.12%, 96.43%, 69.56%, and 84.5%. To avoid missing pDDIs, utilizing multiple drug interaction databases may be of benefit.