Document Detail


Frequency and nature of drug-drug interactions in a Swiss primary and secondary acute care hospital.
MedLine Citation:
PMID:  22327947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
QUESTIONS UNDER STUDY: Drug-drug interactions (DDI) are considered a risk factor in medication safety and computerised alerting tools are increasingly promoted and implemented in order to detect and minimise DDI. As only little is known about the frequency and nature of DDI in hospitalised patients in Switzerland as well as about the usefulness of current alerting systems, this analysis based on a computerised medication record in a typical regional hospital setting was performed.
METHODS: All inpatients with at least one drug prescription between 2006 and 2010 were included. A total of 1,654,987 prescriptions were analysed with regard to the maximal seriousness level of DDI between each added prescription versus the existing prescription and with regard to all underlying DDI.
RESULTS: On average, each inpatient received 16 different drugs including on-demand prescriptions and encountered 5 DDI. A total of 27% of all prescriptions caused DDI. Within the last 12 months, 5% of all DDI were classified in category 1 (contraindicated), 3% in category 2, 53% in category 3, 8% in category 4 and 31% in category 5. The vast majority of DDI were caused by a very limited number of drugs.
DISCUSSION: Drug-drug interactions were very frequent and were very stable over the years studied, involving on average 27% of all prescriptions and 44% in internal medicine. Only a very limited amount of drugs were responsible for the vast majority of DDI, especially when the most severe categories of DDI were considered. Most of the severe DDI alerts could be automatically handled, if for example laboratory values could be taken into account. The DDI database should ideally be supplemented by information enabling more sophisticated computerised support in order to deliver more reasonable results from DDI checks.
Authors:
Marc Oertle
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-02-10
Journal Detail:
Title:  Swiss medical weekly     Volume:  142     ISSN:  1424-3997     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-05-29     Revised Date:  2013-08-07    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  w13522     Citation Subset:  IM    
Affiliation:
Spital Thun-Simmental AG, Department for Internal Medicine and Group of Medical Informatics, Thun, Switzerland. Marc.oertle@spitalstsag.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Adverse Drug Reaction Reporting Systems*
Aged
Drug Interactions*
Drug Prescriptions / statistics & numerical data*
Emergency Service, Hospital*
Hospitalization / statistics & numerical data*
Humans
Medical Order Entry Systems*
Medication Errors / prevention & control*
Middle Aged
Retrospective Studies
Switzerland

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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