Impact of Definitive Drug–Drug Interaction Testing on Medication Management and Patient Care

Abstract

Background and ObjectiveAegis Sciences Corporation developed a test (InterACT Rx™) that objectively and definitively identifies substances known to interact with drug–drug interaction-prone medications commonly prescribed in the treatment of chronic pain and behavioral health disorders. The objective of this study was to assess the severity of identified drug–drug interactions, the reduction in the frequency and severity of identified drug–drug interactions, and the impact of the test on healthcare utilization.MethodsPatients with chronic pain, behavioral health disorders, or both who had one or more drug–drug interaction tests and one or more drug–drug interactions identified in the study period were included. Drug–drug interaction test results described the number and severity of interactions and detected substances involved in drug–drug interactions. Patients’ electronic medical records were obtained to analyze outpatient visits and prescription medications. The cost of outpatient visits was based on the Medicare Physician Fee Schedule. Outcomes were compared between the pre- and post-study index periods to determine the impact of the drug–drug interaction test on patient care.ResultsA total of 262 patients were included. The majority of drug–drug interactions detected (77.9%) at index were of moderate severity. The number of monthly all-cause and pain-related outpatient visits was reduced in the post-index period compared with the pre-index period (0.74–0.54 and 0.69–0.49, respectively). Associated costs were reduced from US$64.92 to US$51.20, and from US$62.42 to US$47.62, (p < 0.0001 for both) for all-cause and pain-related outpatient visits, respectively. Follow-up drug–drug interaction testing for 43 patients revealed that previously reported drug–drug interactions at the index test were no longer identified in the subsequent test for 39.5% of patients.ConclusionsEmploying a definitive test to detect substances whose interactions may cause adverse drug events can enhance a provider’s insights, drive clinical decision making, and improve patient outcomes.Electronic supplementary materialThe online version of this article (10.1007/s40801-018-0143-z) contains supplementary material, which is available to authorized users.

Overactive Bladder Prescribing Considerations: The Role of Polypharmacy, Anticholinergic Burden, and CYP2D6 Drug‒Drug Interactions

“…Many hospital admissions of older adults for drug toxicity occur after administration of a drug known to cause DDIs [ 34 ]. Although continuous monitoring for DDIs and adjustment of medications require diligence on the part of treating clinicians to ensure patient safety, studies have shown that evaluating polypharmacy and DDIs and updating treatment plans accordingly is associated with decreased healthcare and medication costs [ 35 , 36 ]. Furthermore, deprescribing of medications should be considered for patients with OAB who are receiving polypharmacy; in such cases, it may be necessary for providers to carefully consider baseline medication use, prioritize medications, and discontinue or change medications (e.g., from anticholinergics for OAB to adrenergic agonists) to optimize clinical outcomes [ 27 ].…”

Clinical Opportunities for Germline Pharmacogenetics and Management of Drug-Drug Interactions in Patients With Advanced Solid Cancers

“…7,8 Similarly, DDIs are known to contribute to adverse drug events, 9,10 and strategies to manage DDIs have been shown to improve patient outcomes. 11 Given their important clinical implications, recommendations to manage DDIs are included both in FDA drug development guidance to industry 12 and in numerous clinical practice guidelines. 13,14…”

Randomized Trial to Improve Primary Care Patient Management and Patient Outcomes Using a Drug–Drug Interaction Test: Confirmation of the DECART Simulated Patient Clinical Utility Trial Results

“…Drug–drug interactions (DDIs) are underdiagnosed, accounting for more than 30% of all adverse drug events (ADEs) [ 1 , 2 , 3 ], which cost the collective healthcare system an estimated USD 30.1 billion [ 4 , 5 , 6 , 7 ]. The number of patients taking five or more prescription drugs has more than doubled between 1988 and 2018 [ 8 ], while past research confirms that the risk of an ADE or DDI increases with polypharmacy [ 9 ], highlighting the urgent need for a DDI test with demonstrable clinical utility.…”