Abstract
Objective
Computerised surveillance systems have become available for screening potential adverse drug interactions during drug prescribing and dispensing. The purpose of this study was to analyse the frequency and profile of alerts given by one such system in two community pharmacies in Finland.
Methods
In a prospective study, all interaction alerts given by the surveillance system were collated during September–November 2004 in two community pharmacies in Southern Finland. The alerts were categorised into four classes (A–D) according to their clinical significance.
Results
During the 3-month study period, a total of 39,539 prescriptions were dispensed. The system flagged 3,861 prescriptions as having potential interactions (9.8% of all prescriptions). Since one prescription could be the source of several interaction alerts, a total of 5,647 alerts were given. The clinically most significant interactions (class D) represented 0.4% of prescriptions (3.0% of all interactions). Class C alerts were most prevalent (9.4% of all prescriptions, 65.9% of all interactions). The most commonly encountered interaction in class D was between warfarin and non-steroidal anti-inflammatory drugs.
Conclusions
Although the incidence of potentially most hazardous interactions in prescriptions is rather low in this study (0.4%), the overall incidence is relatively high (9.8%). Implementation of the interaction surveillance system in the participating pharmacies makes it possible to study in the future in quantitative terms whether the quality of drug dispensing is improved.
Similar content being viewed by others
References
Battistella M, Mamdami MM, Juurlink DN, Rabeneck L, Laupacis A (2005) Risk of upper gastrointestinal hemorrhage in warfarin users treated with nonselective NSAIDs or COX-2 inhibitors. Arch Intern Med 165:189–192
Baxter K (Ed) Stockley’s drug interactions. London: Pharmaceutical Press. Electronic version (2005)
Becker ML, Kallewaard M, Caspers PWJ, Schalekamp T, Stricker BHC (2005) Potential determinants of drug-drug interaction associated dispensing in community pharmacies. Drug Safety 28:371–378
Bjerrum L, Andersen M, Petersen G, Kragsturp J (2003) Exposure to potential drug interactions in primary health care. Scand J Prim Health Care 21:153–158
Brosen K (2004) Some aspects of genetic polymorphism in the biotransformation of antidepressants. Therapie 59:5–12
Buurma H, de Smet PAGM, van den Hoff OP, Egberts CG (2001) Nature, frequency and determinants of prescription modifications in Dutch community pharmacies. Br J Clin Pharmacol 52:85–91
Chen Y-F, Avery AJ, Neil KE, Johnson C, Dewey ME, Stockley IH (2005) Incidence and possible causes of prescribing potentially hazardous/contraindicated drug combinations in general practice. Drug Saf 28:67–80
Egger SS, Drewe J, Schlienger RG (2003) Potential drug-drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol 58:773–778
Glintborg B, Andersen SE, Dalhoff K (2005) Drug-drug interactions among recently hospitalised patients - frequent but mostly clinically insignificant. Eur J Clin Pharmacol 61:675–681
Halkin H, Katzir I, Kurman I, Jan J, Malkin BB (2001) Preventing drug interactions by online prescription screening in community pharmacies and medical practices. Clin Pharmacol Ther 69:260–265
Lazarou J, Pomeranz BH, Corey PN (1998) Incidence of adverse drug reactions in hospitalized patients. JAMA 279:1200–1205
Merlo J, Liedholm H, Lindblad U, Björck-Linne A, Fält J, Lindberg G, Melander A (2001) Prescriptions with potential drug interactions dispensed at Swedish pharmacies in January 1999: cross sectional study. BMJ 323:427–428
Roughead EE, Gilbert AL, Primrose JG, Sansom LN (1998) Drug-related hospital admission: a review of Australian studies published 1988–1996. Med J Aust 165:405–408
Schneeweiss S, Hasford J, Göttler M, Hoffmann A, Riethling AK, Avorn J (2002) Admissions caused by adverse drug events to internal medicine and emergency departments in hospitals: a longitudinal population-based study. Eur J Clin Pharmacol 58:285–291
Sipilä J, Klaukka T, Martikainen J, Himberg J-J (1995) Occurrence of potentially harmful drug combinations among Finnish primary care patients. Int Pharm J 9:104–107
Tamblyn R, Huang A, Perreault R, Jacques A, Roy A, Hanley J, McLeod P, Laprise R (2003) The medical office of the 21st century (MOXXI): effectiveness of computerized decision-making support in reducing inappropriate prescribing in primary care. CMAJ 169:549–556
Yeom JH, Park JS, Oh OH, Shin HT, Oh JM (2005) Identification of inappropriate drug prescribing by computerized, retrospective DUR screening in Korea. Ann Pharmacother 39:1918–1923
Acknowledgements
We are grateful to the personnel of the participating pharmacies (Kuusankoski I Community Pharmacy and Lauttasaari Central Pharmacy) for their contribution to this study. We thank Ewen MacDonald, Kirsti Laitinen (Department of Pharmacology and Toxicology, University of Kuopio) for help in preparing the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Heikkilä, T., Lekander, T. & Raunio, H. Use of an online surveillance system for screening drug interactions in prescriptions in community pharmacies. Eur J Clin Pharmacol 62, 661–665 (2006). https://doi.org/10.1007/s00228-006-0149-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00228-006-0149-4