The Effectiveness of Computerized Drug Interaction Screening Programs in Hospitals

Jankel, Charlotte A.; Speedie, Stuart M.; McMillan, John A.

doi:10.1177/009286159002400309

Cited by 2 publications

(2 citation statements)

References 4 publications

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“…Previous studies have found discrepancies in DDI references and computerized screening systems with respect to classifying the severity of DDIs. 5,8 More recently, Abarca et al found practically no agreement between 4 commonly used DDI references with regard to the classification of the severity of interactions considered to be of highest clinical importance. 7 Armstrong and Denemark evaluated pharmacists' responses to drug utilization review (DUR) alerts, which included DDI alerts, in a Medicaid population.…”

Section: ■■ Discussionmentioning

confidence: 99%

Evaluation of the Performance of Drug-Drug Interaction Screening Software in Community and Hospital Pharmacies

Abarca

Colón

Wang³

et al. 2006

JMCP

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harmacists play an important role in protecting the public from the dangers posed by potential drug-drug interactions (DDIs), which have been identified as an important subset of medication errors.1 They are uniquely trained to recognize medication-related problems and have the opportunity to review the medication profiles of patients in the inpatient and outpatient setting before dispensing occurs.One of the tools that pharmacists rely on to review medication profiles for DDIs is computerized screening for DDIs. Computerized screening for DDIs and other potential drug-related problems is embedded within most pharmacy computer systems that are used in community and hospital pharmacies and also is included in the prospective, online drug utilization review provided by pharmacy benefit managers. While manual review of medication regimens can be performed by pharmacists, recognition of DDIs without the use of an aid (e.g., drug interaction reference, computer program) only identifies approximately 70% of DDIs in a 2-drug regimen and the proportion decreases substantially as the number of medications increases.2 Thus, computerized DDI screening has the potential to significantly improve the recognition of potentially harmful DDIs beyond what can be achieved with manual review alone. 3Research on the performance of computerized DDI screening software and the references they are based on have found problems in the ability to provide consistent information and screen for clinically significant DDIs. [4][5][6][7][8] For example, in 2001, Hazlet et al. ABSTRACTBACKGROUND: Computerized drug-drug interaction (DDI) screening is widely used to identify potentially harmful drug combinations in the inpatient and outpatient setting.OBJECTIVE: To evaluate the performance of drug-drug interaction (DDI) screening software in identifying select clinically significant DDIs in pharmacy computer systems in community and hospital pharmacies.

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Section: ■■ Discussionmentioning

confidence: 99%

Evaluation of the Performance of Drug-Drug Interaction Screening Software in Community and Hospital Pharmacies

Abarca

Colón

Wang³

et al. 2006

JMCP

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“…Proprietary pharmacy systems exist that perform this function, but require that all of a patient's prescriptions be filled at the same pharmacy or chain. Many software programs are commercially available and have been reviewed in the literature, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] but these have not become widely used in the emergency department (ED).…”

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confidence: 99%

Physician versus Computer Knowledge of Potential Drug Interactions in the Emergency Department

Langdorf

Fox

Marwah

et al. 2000

Academic Emergency Medicine

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Abstract. Introduction: Proliferation of Food and Drug Administration-approved drugs makes it impossible for emergency medicine (EM) faculty to stay current on potential interactions between drugs, and with diseases, laboratory tests, and ethanol. A computer database may augment physician knowledge. Objectives: To compare the performance of EM faculty and an ''expert'' emergency physician (EP) with that of a criterion standard computer database in identifying potential drug interactions, and to report the incidence of drug-ethanol and drug-laboratory test interactions. Methods: This was a retrospective review of 276 emergency department charts for drug, ethanol, lab, and medical history. Evaluation by both EM faculty and an ''expert'' EP of patient history was done to identify potential interactions, and comparison with the Micromedex Drug-Reax database for potential interactions (graded minor, moderate, or major) was made. Clinical significance of potential interactions was judged by a second EM faculty member. Results: Seventeen percent of the patients had potential drug-drug interactions, and 25% of these were judged to be clinically significant. Up to 52% of the patients had potential drug-ethanol interactions, while 38% of the patients could have potential druglab interactions. Sensitivity, specificity, and positive and negative predictive values of the EM faculty for potential drug-drug interactions compared with the computer were poor, at 14%, 58%, 6%, and 23%, respectively. The corresponding values for the ''expert'' EP were 25%, 86%, 26%, and 85%. The ''expert'' EP was statistically better than the EM faculty, but still less sensitive and predictive than the computer. Conclusions: A computer can aid the physician in avoiding potential drug interactions. Prospective validation of these findings should be done.

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The Effectiveness of Computerized Drug Interaction Screening Programs in Hospitals

Cited by 2 publications

References 4 publications

Evaluation of the Performance of Drug-Drug Interaction Screening Software in Community and Hospital Pharmacies

Evaluation of the Performance of Drug-Drug Interaction Screening Software in Community and Hospital Pharmacies

Physician versus Computer Knowledge of Potential Drug Interactions in the Emergency Department

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