Research Activities, October 2011: Patient Safety and Quality: Less than half of pharmacy computer systems studied correctly identified drug-drug interactions

Patient Safety and Quality



Less than half of pharmacy computer systems studied correctly identified drug-drug interactions

Drug interaction computer programs alert the pharmacist to an adverse interaction between a medication a patient is prescribed and other medications the patient is already taking or also being prescribed. This computer decision support (CDS) tool has been a mainstay of pharmacy software packages for many years and is now available in many computerized prescription order-entry systems. Researchers visited 64 participating Arizona pharmacies to analyze their information systems and associated CDS software's ability to detect drug-drug interactions (DDIs). They found that only 28 percent of surveyed pharmacy systems correctly identified all 19 DDIs and non-interactions of mainly cardiovascular drugs.

The researchers chose the oral cardiovascular medications based on their widespread use, clinical importance, propensity to cause adverse events, and level of documentation. They examined pharmacy computer responses to prescription orders for a standardized fictitious patient that consisted of 18 different medications, including 19 drug pairs of interest; 13 had clinically significant DDIs and six were non-interacting pairs.

For all of the 64 participating pharmacies, the median percentage of correct DDI responses was 89 percent. The digoxin and itraconazole drug pair was incorrectly identified more than any other DDI pair. The presence or absence of an alert regardless of its severity level was the basis for determining whether a pharmacy's software response was classified as correct. The community and in-patient pharmacies studied used a total of 24 different software vendors for their DDI systems.

The current study confirms continued variability in system performance across and within pharmacy organizations. Comprehensive system improvements in the manner in which pharmacy information systems identify potential DDIs are warranted, suggest the researchers. Their study was sponsored by the Agency for Healthcare Research and Quality (HS17001).

See "Ability of pharmacy clinical decision-support software to alert users about clinically important drug-drug interactions," by Kim R. Saverno, B.S.Pharm., Lisa E. Hines, Pharm.D., Terri L. Warholak, Ph.D., R.P.H., and others in the Journal of the American Medical Informatics Association 18, pp. 32-37, 2011.
Research Activities, October 2011: Patient Safety and Quality: Less than half of pharmacy computer systems studied correctly identified drug-drug interactions