| Clarity and applicability of drug-drug interaction management guidelines: a systematic appraisal by general practitioners and community pharmacists in the Netherlands. | |
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MedLine Citation:
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PMID: 21751828 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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 non-directive advice using words such as 'consider' and 'regularly'. Conclusions: Developers of DDI management guidelines should take the appropriate domains of the AGREE Instrument into consideration in their development processes. The applicability of DDI management guidelines should be pretested before publishing. To improve guideline quality, more attention should particularly be paid to the available tools for applications and cost implications. |
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Authors:
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Annemieke Floor-Schreudering; Peter A G M De Smet; Henk Buurma; Sonia Amini; Marcel L Bouvy |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Drug safety : an international journal of medical toxicology and drug experience Volume: 34 ISSN: 0114-5916 ISO Abbreviation: Drug Saf Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-07-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9002928 Medline TA: Drug Saf Country: New Zealand |
Other Details:
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Languages: eng Pagination: 683-90 Citation Subset: IM |
Affiliation:
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SIR Institute for Pharmacy Practice and Policy, Leiden, the Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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