Effect of drug interactions on outcomes of patients receiving warfarin or theophylline

Jankel, Charlotte A.; McMillan, John A.; Martin, Bradley C.

doi:10.1093/ajhp/51.5.661

Cited by 22 publications

(14 citation statements)

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“…33 One study explored the effect of warfarin-related DDIs on health care resource consumption and found that patients receiving warfarin and another interacting medication usually had prolonged hospital stays and higher use of laboratory tests compared with patients receiving warfarin alone. 34 Proper management of DDIs is based first on recognizing the potential interaction and consequently taking the necessary measures to reduce the likelihood of an adverse outcome, such as therapeutic drug monitoring or dose adjustment. 32 Previous studies have found that many VA practitioners fail to identify clinically important interactions.…”

Section: Discussionmentioning

confidence: 99%

Potential drug–drug interactions within Veterans Affairs medical centers

Mahmood¹,

Malone²,

Skrepnek

et al. 2007

American Journal of Health-System Pharmacy

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Section: Discussionmentioning

confidence: 99%

Potential drug–drug interactions within Veterans Affairs medical centers

Mahmood¹,

Malone²,

Skrepnek

et al. 2007

American Journal of Health-System Pharmacy

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“…3,[11][12][13] Provider order entry systems may confer specific benefit in decreasing errors and preventable adverse out- comes, at least as shown in the inpatient setting. 3,14 However, how to achieve maximum benefit from drug alert systems is still an area of contention.…”

Section: Discussionmentioning

confidence: 99%

Clinical Relevance of Automated Drug Alerts From the Perspective of Medical Providers

Spina

Glassman²,

Belperio³

et al. 2005

Am J Med Qual

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The authors used a real-time survey instrument and subsequent focus group among primary care clinicians at a large healthcare system to assess usefulness of automated drug alerts. Of 108 alerts encountered, 0.9% (n = 1) represented critical alerts, and 16% (n = 17) were significant drug interaction alerts. Sixty-one percent (n = 66) involved duplication of a medication or medication class. The rest (n = 24) involved topical medications, inhalers, or vaccines. Of the 84 potentially relevant alerts, providers classified 11% (9/84), or about 1 in 9, as useful. Drug interaction alerts were more often deemed useful than drug duplication alerts (44.4% versus 1.5%, P < .001). Focus group participants generally echoed these results when ranking the relevance of 15 selected alerts, although there was wide variance in ratings for individual alerts. Hence, a "smarter" system that utilizes a set of mandatory alerts while allowing providers to tailor use of other automated warnings may improve clinical relevance of drug alert systems.

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“…Warfarin is highly susceptible to drug interactions [25] and the initiation of new medications is often the cause of over-or under-anticoagulation [26]. Warfarin drug interactions increase morbidity and mortality, and increase healthcare costs [27]. This model not withstanding, a systematic review of available evidence completed in 2005 rated warfarin drug interaction reports according to interaction direction, clinical severity, and quality of evidence and developed lists of warfarin drug interactions considered highly probable, probable, possible, and highly improbable [28].…”

Section: Clinical Questionmentioning

confidence: 99%

Prevention and treatment of bleeding complications in patients receiving vitamin K antagonists, Part 1: Prevention

Ageno

García²,

Aguilar

et al. 2009

American J Hematol

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Oral anticoagulant therapy with coumarins is widely\ud used for the prevention and treatment of venous and\ud arterial thrombosis. The most common complication of\ud vitamin K antagonist therapy is bleeding, with major\ud bleeding events occurring in 1–3% of patients annually.\ud Although a number of potential predictors for bleeding\ud have been described, little research is available to provide\ud evidence-based guidelines for the prevention of\ud bleeding. To address this knowledge gap, we assembled\ud a panel of international experts and posed a series of\ud focused clinical questions. The experts were asked to\ud perform a systematic literature review and summarize the\ud results of that review within the context of their clinical\ud question. In many cases, data were lacking and the\ud experts were asked to supplement their answer with clinical\ud expertise. To minimize bias the reviews were vetted\ud by three internationally recognized scholarly bodies. Our\ud goal in this project is to provide ‘‘best evidence’’ for\ud clinicians faced with the problem of minimizing the risk\ud of bleeding in patients on vitamin K antagonist therap

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Effect of drug interactions on outcomes of patients receiving warfarin or theophylline

Cited by 22 publications

References 0 publications

Potential drug–drug interactions within Veterans Affairs medical centers

Potential drug–drug interactions within Veterans Affairs medical centers

Clinical Relevance of Automated Drug Alerts From the Perspective of Medical Providers

Prevention and treatment of bleeding complications in patients receiving vitamin K antagonists, Part 1: Prevention

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