Drug interaction alerts in older primary care patients, and related medically justified actions.
Purpose: To describe presented interaction alerts in older patients, and the extent to which these require further medical action for the specific patient or are already being addressed. Methods: Interaction alerts presented at a physician consultation, for 274 consecutive primary care patients trea...
| Published in: | European Journal of Clinical Pharmacology Vol. 78; no. 7; pp. 1115 - 1127 |
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| Main Authors: | , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Jul2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157415219&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157415219 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Jul2022 vid: 78 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 157415219 157415219 157415219 10.1007/s00228-022-03292-4 157415219 ppf: 1115 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Drug interaction alerts in older primary care patients, and related medically justified actions. aug: au: Tukukino, Carina Parodi López, Naldy Svensson, Staffan A. Wallerstedt, Susanna M. affil: Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden sug: subj: Drug Interactions In Old Age Primary Health Care Human Male Female Aged Decision Support Systems, Clinical Medication Systems Utilization Data Analysis Software Aged: 65+ years Male Female ab: Purpose: To describe presented interaction alerts in older patients, and the extent to which these require further medical action for the specific patient or are already being addressed. Methods: Interaction alerts presented at a physician consultation, for 274 consecutive primary care patients treated with two or more drugs (median age: 75 years; 59% female), were extracted. These alerts are based on Janusmed, a decision support integrated in the medical records that provides recommendations for managing the interactions. One general practitioner (GP) and one GP/clinical pharmacologist determined in retrospect, first independently and then in consensus, whether the alerts justified further medical action, considering each patient's health condition. Results: In all, 405 drug interaction alerts in 151 (55%) patients were triggered. Medical action in response was deemed medically justified for 35 (9%) alerts in 26 (17%) patients. These actions most often involved a switch to a less interacting drug from the same drug class (n = 10), a separate intake (n = 9), or the ordering of a laboratory test (n = 8). Out of 531 actions suggested by the alert system, only 38 (7%) were applicable to the specific patient, as, for instance, laboratory parameters were already being satisfactorily monitored or a separate intake implemented. Conclusions: More than every other older patient receives drug treatment that triggers drug interaction alerts. Nine in ten alerts were already being addressed or were not relevant in the clinical setting, whereas, for the remaining tenth, some medical action, that for unknown reasons had not been taken, was reasonable. These findings show that interaction alerts are questionable as indicators of problematic prescribing. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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