Drug-drug interactions and their harmful effects in hospitalised patients

a systematic review and meta-analysis

Wu Yi Zheng, Lauren Richardson, Ling Li, Richard Day, Johanna Westbrook, Melissa Baysari

Research output: Contribution to conferenceAbstract

Abstract

Drug-drug interactions (DDIs) are often avoidable and if undetected, can lead to patient harm. Significant resources continue to be invested in the implementation of electronic alerts in electronic medication management (EMM) systems to reduce DDIs. These alerts trigger at the point of prescribing and are designed to warn prescribers of potential DDIs (pDDIs) at the time a new medication order is placed. However, DDI alerts can interrupt clinical workflow and result in alert fatigue. To determine whether electronic DDI alerts are beneficial and worthy of investment, robust evidence on the prevalence of DDIs among hospitalised patients, and in particular the proportion of DDIs that result in actual harm to patients, is needed.

This systematic review and meta-analysis aimed to determine the prevalence of pDDIs, clinically relevant DDIs, and DDIs that resulted in actual patient harm during hospitalisation. Four databases were scanned for English papers that reported on DDIs in the general inpatient setting from 2000-2016. Twenty-seven papers met inclusion criteria and 21 contained sufficient information to be included in the meta-analysis.

Overall, the meta-analysis revealed that 33% of general patients and 67% of intensive care patients experienced a pDDI during their hospital admission. It was not possible to determine incidence rates of clinically relevant DDIs or DDIs that resulted in actual patient harm as data in these categories were extremely limited. From the only study that reported on actual DDIs, 2% of patients were harmed. Standardisation of DDI definitions and research methods are required to allow incidence rates to be obtained and compared. Studies that go further than measuring pDDIs are critically needed to determine the impact of DDIs on patient safety. To date, there is limited evidence to suggest that electronic alerts reduce patient harm in the hospital setting.
Original languageEnglish
Number of pages1
Publication statusPublished - 2018
EventNMS Conference - Canberra, Australia
Duration: 31 May 20181 Jun 2018

Conference

ConferenceNMS Conference
CountryAustralia
CityCanberra
Period31/05/181/06/18

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