Identifying effective strategies to prevent drug-drug interactions in hospital: A user-centered approach

Background: Drug-drug interactions (DDIs) are an important and preventable cause of medication errors in hospitals. Research has shown that doctors and pharmacists are often unable to recognise potential DDIs, suggesting that a strategy to aid in DDI detection and prevention is needed. Recent developments in technology have seen new strategies emerge for preventing DDIs but these strategies are rarely evaluated and are typically implemented with little input from the individuals using them. Aim: The aim of this study was to determine the opinions of both experts and users (doctors) on strategies available to assist in the identification and prevention of DDIs. Method: Eight drug safety experts and 18 doctors took part in semi-structured interviews. Participants were asked about their confidence in identifying DDIs and their views on strategies to prevent DDIs. Results: No doctors reported complete confidence in identifying dangerous DDIs, with junior doctors appearing less confident than senior doctors. Most doctors believed that computerised alerts would be the most effective strategy for preventing DDIs, while experts were more critical of alerts. Conclusion: The lack of confidence displayed by doctors in their ability to identify DDIs suggests that a strategy that does not rely on individuals seeking out the information themselves would be most appropriate. While a large number of problems related to DDI alert implementation have been reported in the literature (e.g. alert overload), users appeared to be receptive to the idea of being alerted. By ensuring users are aware of the limitations of the system and involving them in DDI strategy design we expect greater use and satisfaction with the adopted strategy.