Identification of serious drug-drug interactions

Results of the partnership to prevent drug-drug interactions

Daniel C. Malone, Jacob Abarca, Philip D. Hansten, Amy J. Grizzle, Edward P. Armstrong, Robin C. Van Bergen, Babette S. Duncan-Edgar, Steven L. Solomon, Richard B. Lipton

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Objective: To develop a list of clinically important drug-drug interactions (DDIs) likely to be encountered in community and ambulatory pharmacy settings and detected by a computerized pharmacy system. Design: Cross-sectional, one-time evaluation. Setting: United States in fall 2001. Participants: An expert panel comprising two physicians, two clinical pharmacists, and an expert on DDIs. Interventions: Systematic review of drug interaction compendia and published literature, ratings (on a 1 to 10 scale) of various clinical aspects of DDIs (e.g., clinical importance, quality and quantity of evidence, causal relationship, risk of morbidity and mortality), and a modified Delphi consensus-building process. Main Outcome Measure: Panelists' opinions about clinical importance of DDIs. Results: The expert panel considered 56 DDIs. Of these, 28 had a mean clinical importance score of 8.0 or more. The ratings for clinical importance ranged from 3.2 to 9.6, with a mean ± SD of 7.5 ± 1.5 across the combinations examined. The mean score for the quality of literature suggesting the interaction exists ranged from 1.0 to 9.6, with a mean ± SD of 5.8 ± 2.5. In terms of substantiation of the interactions evaluated, the mean ± SD rating was 6.3 ± 2.2, with a range from 1.4 to 9.2. Through the modified Delphi process, the panel determined that 25 interactions were clinically important. Conclusion: Using an expert panel and a standard evaluation tool, 25 clinically important drug interactions that are likely to occur in the community and ambulatory pharmacy settings were identified. Pharmacists should take steps to prevent patients from receiving these interacting medications, and computer software vendors should focus interaction alerts on these and similarly important DDIs.

Original languageEnglish (US)
Pages (from-to)142-151
Number of pages10
JournalJournal of the American Pharmacists Association
Volume44
Issue number2
DOIs
StatePublished - 2004

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Drug interactions
Drug Interactions
Pharmaceutical Preparations
Pharmacies
Pharmacists
Software
Outcome Assessment (Health Care)
Morbidity
Physicians
Mortality

Keywords

  • Drug utilization review
  • Drug-drug interactions
  • Medication errors
  • Patient safety

ASJC Scopus subject areas

  • Pharmacy
  • Pharmacology
  • Pharmacology (nursing)

Cite this

Identification of serious drug-drug interactions : Results of the partnership to prevent drug-drug interactions. / Malone, Daniel C.; Abarca, Jacob; Hansten, Philip D.; Grizzle, Amy J.; Armstrong, Edward P.; Van Bergen, Robin C.; Duncan-Edgar, Babette S.; Solomon, Steven L.; Lipton, Richard B.

In: Journal of the American Pharmacists Association, Vol. 44, No. 2, 2004, p. 142-151.

Research output: Contribution to journalArticle

Malone, DC, Abarca, J, Hansten, PD, Grizzle, AJ, Armstrong, EP, Van Bergen, RC, Duncan-Edgar, BS, Solomon, SL & Lipton, RB 2004, 'Identification of serious drug-drug interactions: Results of the partnership to prevent drug-drug interactions', Journal of the American Pharmacists Association, vol. 44, no. 2, pp. 142-151. https://doi.org/10.1331/154434504773062591
Malone, Daniel C. ; Abarca, Jacob ; Hansten, Philip D. ; Grizzle, Amy J. ; Armstrong, Edward P. ; Van Bergen, Robin C. ; Duncan-Edgar, Babette S. ; Solomon, Steven L. ; Lipton, Richard B. / Identification of serious drug-drug interactions : Results of the partnership to prevent drug-drug interactions. In: Journal of the American Pharmacists Association. 2004 ; Vol. 44, No. 2. pp. 142-151.
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