Prevalence of clinically manifested drug interactions in hospitalized patients: A systematic review and meta-analysis

Abstract

This review aims to determine the prevalence of clinically manifested drug-drug interactions (DDIs) in hospitalized patients. Methods PubMed, Scopus, Embase, Web of Science, and Lilacs databases were used to identify articles published before June 2019 that met specific inclusion criteria. The search strategy was developed using both controlled and uncontrolled vocabulary related to the following domains: "drug interactions," "clinically relevant," and "hospital." In this review, we discuss original observational studies that detected DDIs in the hospital setting, studies that provided enough data to allow us to calculate the prevalence of clinically manifested DDIs, and studies that described the drugs prescribed or provided DDI adverse reaction reports, published in either English, Portuguese, or Spanish. Results From the initial 5,999 articles identified, 10 met the inclusion criteria. The pooled prevalence of clinically manifested DDIs was 9.2% (CI 95% 4.0-19.7). The mean number of medications per patient reported in six studies ranged from 4.0 to 9.0, with an overall average of 5.47 ± 1.77 drugs per patient. The quality of the included studies was moderate. The main methods used to identify clinically manifested DDIs were evaluating medical records and ward visits (n = 7). Micromedex® (27.7%) and Lexi-Comp® (27.7%) online reference databases were commonly used to detect DDIs and none of the studies evaluated used more than one database for this purpose.

Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients

“…Most studies on this subject do not focus on the prevalence of clinically relevant DDIs. 30 , 31 A meta‐analysis 32 aimed to determine the prevalence of clinically manifested DDIs in hospitalized patients identified 5999 studies. Of these, only 10 studies met the inclusion criteria and none of them included hospitalized transplant recipients.…”

“…This is an important starting point for advanced forms of clinical decision‐support systems, which should help the physician and pharmacist to identify important pDDIs without generating clinically irrelevant alerts. The studies evaluated in the meta‐analysis 32 used a single source to detect pDDI, without integration into an assisted prescribing program.…”

Pharmaceutical Consultation in Hospitals at Northern Border Region, Saudi Arabia

“…Pharmacist consulting services have been shown to have a positive effect on a number of outcomes, including patient prescription adherence [7,8], hospital admission, mortality, and total health care costs in previous studies [9,10]. Pharmacists may be paid for providing treatment management to Medicare beneficiaries that are at risk of drug complications such as diabetes, asthma, hypertension, or congestive heart failure, or who have several medications that must be used correctly to improve clinical outcomes and reduce the risk of adverse events, such as medication interactions that are dangerous, as well as the clinical benefits associated with chronic diseases, according to the Medicare Modernization Act [2] (2003) [11][12][13][14][15].…”

Current Knowledge about Providing Drug–Drug Interaction Services for Patients—A Scoping Review

“…Physicians and pharmacists, among others, have important roles in making sure patients' treatments are safe and appropriate, for example, by avoiding DDIs. However, DDIs are still a large problem [25,26], indicating that they are sometimes missed by health care professionals. Reasons for missing a potential DDI may be a lack of knowledge about DDIs, a lack of appropriate CDSS in the information system they are using, or due to missing correct information about a patient's current medications, or due to different perceptions about responsibility or lack of time to check for interactions [27][28][29].…”