Drug-drug Interaction between Psychotropic Medications and Medications Used in COVID-19: Comparison of Online Databases (original) (raw)
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Cureus, 2021
Background Information related to drug-drug interactions (DDIs) varies significantly from one drug information (DI) resource to another. These variations pose challenges for healthcare professionals in making the right decisions regarding using some of the drug combinations in needy patients. The objective of this study was to review eight different DI resources for scope, completeness, and consistency of information related to DDIs. Methodology A total of eight DI resources, namely, Micromedex®, Portable Electronic Physician Information Database©, UpToDate®, Medscape.com drug interaction checker, Drugs.com drug interaction checker, Stockley’s Drug Interactions (ninth edition, 2010), Drug Interactions Analysis & Management: Facts and Comparisons 2014 (ninth edition, 2014), and the drug interaction appendix of the British National Formulary-76, were compared. Each DI resource was scored for scope by calculating the percentage of interactions that had an entry in each resource. A comp...
Cureus, 2021
Background Drug interactions are a significant issue in mental illnesses and coronavirus disease 2019 (COVID-19) infections. Inconsistency in drug interaction resources makes prescribing challenging for healthcare professionals. To assess the scope, completeness, and consistency of drug-drug interactions (DDIs) between psychotropic and COVID-19 medications in six specific drug information (DI) databases. Methodology For the comparison, six DI resources were used: Portable Electronic Physician Information Database, Micromedex®, Medscape.com, UpToDate®, Drugs.com drug interaction checker, and WebMD.com drug interaction checker. Using the Statistical Package for the Social Sciences (SPSS) software version 27 (IBM Corp., Armonk, NY), the gathered data were examined for scope, completeness, and consistency. Results Scope scores were higher for PEPID© than all the other resources (p < 0.001) for each comparison. PEPID© had better overall completeness scores (median 5, Interquartile range [IQR] 5 to 5; p<0.05 for each comparison), except for Drugs.com (p < 0.05 for each comparison), and were more remarkable for Micromedex® (median 5, IQR 5 to 5). The Fleiss kappa scores among the six different DI sources were poor (k < 0.20, p < 0.05) for the category of information related to clinical effects and level of documentation, moderate agreement (k = 0.4-0.6, p < 0.05) for the severity and course of action of DDIs, and fair agreement (k = 0.4-0.6, p < 0.05) for mechanism. Conclusion A comprehensive, accurate information among DI resources is essential for healthcare professionals that will significantly impact patient care in the clinical practice. Banking on high-quality resources will help healthcare professionals to make an informed decision while prescribing to avoid inappropriate combinations that can adversely affect patient outcomes.
Clarity and Applicability of Drug-Drug Interaction Management Guidelines
Drug Safety, 2011
Background: Despite the availability and daily use of computerized drug-drug interaction surveillance systems, exposure to potentially relevant drug-drug interactions (DDIs) continues. DDI management guidelines are often inadequate and clear management options are lacking, which attributes to overriding of DDI signals. Although general criteria for the development and reporting of high-quality clinical practice guidelines have been identified, it appears these have not yet been applied to DDI management guidelines. Objectives: The aim of the study was to assess the clarity and applicability of guidelines for the management of potentially harmful DDIs. Methods: We selected 13 DDIs that are potentially harmful for patients and frequently occur in community pharmacy practice in the Netherlands. The clarity and applicability of the management guidelines of these DDIs were appraised using the appropriate two domains-'Clarity and presentation' and 'Applicability', of the validated Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. The appraisal was performed by 12 community pharmacists and 12 general practitioners. The standardized domain scores and mean item scores for 'Clarity and presentation' and 'Applicability' were compared. Results: All DDI management guidelines were generally found to score well on 'Clarity and presentation', but poorly with respect to 'Applicability' (standardized domain scores 68.0 vs 26.1%). Within the domain 'Clarity and presentation', the item 'tools for application' received the lowest scores. Within the domain 'Applicability', cost implications, organizational barriers and key review criteria were all poorly documented. All guidelines presented nondirective advice using words such as 'consider' and 'regularly'.
THE PROFESSIONAL MEDICAL JOURNAL, 2017
There are several clinically significant outcomes of drug-drug interactions (DDIs) which have been classified as one of the serious forms of adverse drug reactions that may lead to prolongation of hospital stays along with severe cases of mortality and morbidities. It may cause due to the selection of two or more interacting drugs to be prescribed to patient. Objectives: Therefore it is indispensable to attain a collective level of therapeutic decision making so that any potential DDIs can be minimized that ultimately turn out to be safe and beneficial to patient. Study Design: The current study is based upon surveys to evaluate utilization of medications that have a narrow therapeutic range with high incidence to develop DDIs and to access the knowledge, attitude as well as practice of using such drug products in relation to these facts, though very few such studies have been identified, yet the relevant data is insufficient locally. The study design was selected to be qualitative and cross sectional. Period: January 2016 till August 2016 in Karachi, Pakistan. Settings: The questionnaire was well constructed for physicians, pharmacists as well as nurses who were selected as the participant of the study and a former consent from the respondents was obtained. Method: Coefficient of spearman correlation & Cronbach's α values were calculated in order to validate the questionnaire (α = 0.927 and p = 0.918). The information based on practice along with demographics of study participant was included as first segment of questionnaire while their knowledge regarding drug interactions was included as second part. Mean scores were calculated and responses were analysed by ANOVA in relation to the knowledge of members relating to drug interactions of vancomycin, warfarin and valproic acid. Results: Mean scores of perception were found in order of 1.590.16, 1.549.02 and 2.020.83 for physicians, pharmacists and nurses. No significant differences were observed between physicians and pharmacists cohorts in identifying the drug interactions whereas noteworthy variations were observed in the group of nurses (p < 0.05). Conclusion: Such investigations are vital in their prospect to highlight the importance for the design, implementation and monitoring of an effectual tool for the guidance of various healthcare members involved in identification and management of DDIs. Furthermore, results also signify the need of sophisticated support systems for valuable clinical judgments.
BMJ (Clinical research ed.), 2015
To identify the number of drug-disease and drug-drug interactions for exemplar index conditions within National Institute of Health and Care Excellence (NICE) clinical guidelines. Systematic identification, quantification, and classification of potentially serious drug-disease and drug-drug interactions for drugs recommended by NICE clinical guidelines for type 2 diabetes, heart failure, and depression in relation to 11 other common conditions and drugs recommended by NICE guidelines for those conditions. NICE clinical guidelines for type 2 diabetes, heart failure, and depression Potentially serious drug-disease and drug-drug interactions. Following recommendations for prescription in 12 national clinical guidelines would result in several potentially serious drug interactions. There were 32 potentially serious drug-disease interactions between drugs recommended in the guideline for type 2 diabetes and the 11 other conditions compared with six for drugs recommended in the guideline ...
Patients’ Use and Perceptions of a Drug-Drug Interaction Database: A Survey of Janusmed Interactions
Pharmacy, 2021
Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register for a personal account. The aim of this study was to investigate why and how patients use the database Janusmed interactions, how they perceive content and usability, and how they would react if they found an interaction. A web-based questionnaire was sent by email to all users who had registered for Janusmed interactions as a “patient” (n = 3219). A total of 406 patients completed the survey (response rate 12.6%). The study shows that there is an interest among patients to use a DDI database to check their own or a relative’s medication. The respondents found the database easy to use and perceive they understand the information aimed at HCP. Most patients stated they would talk to their HCP if they found...
European Journal of Clinical Pharmacology, 2013
Purpose To investigate the impact of the integration of the drug-drug interaction database SFINX into primary health care records on the prevalence of potentially serious drugdrug interactions. Methods The study was a controlled before-and-after study on the prevalence of potential drug-drug interactions before and after the implementation of SFINX at 15 primary healthcare centres compared with 5 centres not receiving the intervention. Data on dispensed prescriptions from health care centres were retrieved from the Swedish prescribed drug register and analysed (post-intervention). All drugs dispensed during each 4 month period were regarded as potentially interacting. Results Use of SFINX was associated with a 17% decrease, to 1.81×10 −3 from 2.15×10 −3 interactions per prescribed drug-drug pair, in the prevalence of potentially serious drugdrug interactions (p00.042), whereas no significant effect was observed in the control group. The change in prevalence of potentially serious drug-drug interactions did not differ significantly between the two study groups. The majority of drug-drug interactions identified were related to chelate formation. Conclusion Prescriptions resulting in potentially serious drug-drug interactions were significantly reduced after integration of the drug-drug interaction database SFINX into electronic health records in primary care. Further studies are needed to demonstrate the effectiveness of drug-drug interaction warning systems.
European Journal of Clinical Pharmacology, 2007
Objectives The increased risk of adverse events in patients receiving potentially interacting drugs has long been recognized. The purpose of the present study was to evaluate the change in the risk of receiving potentially interacting drugs during a period covering three decades and to examine the relative risk of actual drug combinations. Methods The prescriptions from all individuals (about 8,000) with two or more prescriptions during three periods of were collected from an ongoing cohort study in the county of Jämtland, Sweden. The potential interactions were detected by a computerized system. Results The relative risk (RR) of receiving potentially interacting drugs increased for type C interactions [RR: 1.177, 95% confidence interval (CI): 1.104-1.256] and decreased for type D interactions (RR: 0.714, 95% CI: 0.587-0.868) from the period 1983-. The RR was positively correlated to the pronounced increase in polypharmacy; in addition, an exponential relationship was found for the more severe type D interactions. Few interacting drug combinations were responsible for a large proportion of the risk. Conclusion We conclude that the risk of receiving potentially interacting drugs was strongly correlated to the concomitant use of multiple drugs. The pronounced increase in polypharmacy over time implies a growing reason for prescribers and pharmacists to be aware of drug interactions. Recently established national prescription registers should be evaluated for drug interaction vigilance, both clinically and epidemiologically.