Pharmacogenetics of drug–drug interaction and drug–drug–gene interaction: a systematic review on CYP2C9, CYP2C19 and CYP2D6

2017 ◽  
Vol 18 (7) ◽  
pp. 701-739 ◽  
Author(s):  
Muh Akbar Bahar ◽  
Didik Setiawan ◽  
Eelko Hak ◽  
Bob Wilffert
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Gene Interaction ◽  
Drug Drug Interaction

Drug-drug interaction software in clinical practice: a systematic review

2014 ◽  
Vol 71 (2) ◽  
pp. 131-142 ◽  
Author(s):  
Tina Roblek ◽  
Tomaz Vaupotic ◽  
Ales Mrhar ◽  
Mitja Lainscak
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Clinical Practice ◽  
Drug Drug Interaction

scholarly journals Appropriateness of Overridden Alerts in Computerized Physician Order Entry: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Tahmina Nasrin Poly ◽  
Md.Mohaimenul Islam ◽  
Hsuan-Chia Yang ◽  
Yu-Chuan (Jack) Li
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Drug Allergy ◽  
Adverse Drug Events ◽  
Clinical Decision ◽  
Drug Drug Interaction ◽  
Indispensable Tool ◽  
Physician Order Entry ◽  
Clear Information

BACKGROUND The clinical decision support system (CDSS) has become an indispensable tool for reducing medication errors and adverse drug events. However, numerous studies have reported that CDSS alerts are often overridden. The increase in override rates has raised questions about the appropriateness of CDSS application along with concerns about patient safety and quality of care. OBJECTIVE The aim of this study was to conduct a systematic review to examine the override rate, the reasons for the alert override at the time of prescribing, and evaluate the appropriateness of overrides. METHODS We searched electronic databases, including Google Scholar, PubMed, Embase, Scopus, and Web of Science, without language restrictions between January 1, 2000 and March 31, 2019. Two authors independently extracted data and crosschecked the extraction to avoid errors. The quality of the included studies was examined following Cochrane guidelines. RESULTS We included 23 articles in our systematic review. The range of average override alerts was 46.2%-96.2%. An average of 29.4%-100% of the overrides alerts were classified as appropriate, and the rate of appropriateness varied according to the alert type (drug-allergy interaction 63.4%-100%, drug-drug interaction 0%-95%, dose 43.9%-88.8%, geriatric 14.3%-57%, renal 27%-87.5%). The interrater reliability for the assessment of override alerts appropriateness was excellent (kappa=0.79-0.97). The most common reasons given for the override were “will monitor” and “patients have tolerated before.” CONCLUSIONS The findings of our study show that alert override rates are high, and certain categories of overrides such as drug-drug interaction, renal, and geriatric were classified as inappropriate. Nevertheless, large proportions of drug duplication, drug-allergy, and formulary alerts were appropriate, suggesting that these groups of alerts can be primary targets to revise and update the system for reducing alert fatigue. Future efforts should also focus on optimizing alert types, providing clear information, and explaining the rationale of the alert so that essential alerts are not inappropriately overridden.

scholarly journals The impact of CYP2D6 mediated drug-drug interaction: a systematic review on a combination of metoprolol and paroxetine/fluoxetine

2018 ◽  
Vol 84 (12) ◽  
pp. 2704-2715 ◽  
Author(s):  
Muh. Akbar Bahar ◽  
Jasper Kamp ◽  
Sander D. Borgsteede ◽  
Eelko Hak ◽  
Bob Wilffert
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Drug Drug Interaction ◽  
The Impact

scholarly journals Appropriateness of Overridden Alerts in Computerized Physician Order Entry: Systematic Review

10.2196/15653 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e15653 ◽  
Author(s):  
Tahmina Nasrin Poly ◽  
Md.Mohaimenul Islam ◽  
Hsuan-Chia Yang ◽  
Yu-Chuan (Jack) Li
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Drug Allergy ◽  
Adverse Drug Events ◽  
Clinical Decision ◽  
Drug Drug Interaction ◽  
Indispensable Tool ◽  
Physician Order Entry ◽  
Clear Information

Background The clinical decision support system (CDSS) has become an indispensable tool for reducing medication errors and adverse drug events. However, numerous studies have reported that CDSS alerts are often overridden. The increase in override rates has raised questions about the appropriateness of CDSS application along with concerns about patient safety and quality of care. Objective The aim of this study was to conduct a systematic review to examine the override rate, the reasons for the alert override at the time of prescribing, and evaluate the appropriateness of overrides. Methods We searched electronic databases, including Google Scholar, PubMed, Embase, Scopus, and Web of Science, without language restrictions between January 1, 2000 and March 31, 2019. Two authors independently extracted data and crosschecked the extraction to avoid errors. The quality of the included studies was examined following Cochrane guidelines. Results We included 23 articles in our systematic review. The range of average override alerts was 46.2%-96.2%. An average of 29.4%-100% of the overrides alerts were classified as appropriate, and the rate of appropriateness varied according to the alert type (drug-allergy interaction 63.4%-100%, drug-drug interaction 0%-95%, dose 43.9%-88.8%, geriatric 14.3%-57%, renal 27%-87.5%). The interrater reliability for the assessment of override alerts appropriateness was excellent (kappa=0.79-0.97). The most common reasons given for the override were “will monitor” and “patients have tolerated before.” Conclusions The findings of our study show that alert override rates are high, and certain categories of overrides such as drug-drug interaction, renal, and geriatric were classified as inappropriate. Nevertheless, large proportions of drug duplication, drug-allergy, and formulary alerts were appropriate, suggesting that these groups of alerts can be primary targets to revise and update the system for reducing alert fatigue. Future efforts should also focus on optimizing alert types, providing clear information, and explaining the rationale of the alert so that essential alerts are not inappropriately overridden.

Drug Disposition and Drug-Drug Interaction Data in 2013 FDA New Drug Applications: A Systematic Review

2014 ◽  
Vol 42 (12) ◽  
pp. 1991-2001 ◽  
Author(s):  
Jingjing Yu ◽  
Tasha K. Ritchie ◽  
Aditi Mulgaonkar ◽  
Isabelle Ragueneau-Majlessi
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Drug Disposition ◽  
Interaction Data ◽  
New Drug ◽  
Drug Drug Interaction

Information Technology-Based Interventions to Improve Drug-Drug Interaction Outcomes: A Systematic Review on Features and Effects

2016 ◽  
Vol 41 (1) ◽  
Author(s):  
Ehsan Nabovati ◽  
Hasan Vakili-Arki ◽  
Zhila Taherzadeh ◽  
Mohammad Reza Saberi ◽  
Stephanie Medlock ◽  
...  
Keyword(s):  
Systematic Review ◽  
Information Technology ◽  
Drug Interaction ◽  
Drug Drug Interaction

scholarly journals Prevalence of potential drug- drug interactions and associated factors among outpatients and inpatients in Ethiopian Hospitals: a systematic review and Meta-analysis of observational studies

2020 ◽  
Author(s):  
Wondim Ayenew ◽  
Getahun Asmamaw ◽  
Arebu Issa
Keyword(s):  
Systematic Review ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Potential Drug ◽  
Comorbid Disease ◽  
Factors Associated ◽  
Drug Drug Interaction

Abstract Background: Drug-drug interaction is an emerging threat to public health. Currently, there is an increase in comorbid disease, polypharmacy, and hospitalization in Ethiopia. Thus, the possibility of drug-drug interaction occurrence is high in hospitals. This study aims to summarize the prevalence of potential drug-drug interactions and associated factors in Ethiopian hospitals.Methods: A literature search was performed by accessing legitimate databases in PubMed/MEDLINE, Google Scholar, and Research Gate for English-language publications. To fetch further related topics advanced search was also applied in Science Direct and HINARI databases. The search was conducted on August 3 to 25, 2019. All published articles available online until the day of data collection were considered. Outcome measures were analyzed with Open Meta Analyst and CMA version statistical software. Der Simonian and Laird’s random effect model, I2 statistics, and Logit event rate were also performed.Results: A total of 14 studies remained eligible for inclusion in systematic review and meta-analysis. From the included studies, around 8,717 potential drug-drug interactions were found in 3,259 peoples out of 5,761 patients. The prevalence of patients with potential drug-drug interactions in Ethiopian hospitals was found to be 72.2% (95% confidence interval: 59.1%, 85.3%). Based on severity, the prevalence of major, moderate, and minor potential drug-drug interaction was 25.1%, 52.8%, 16.9%, respectively, also 1.27% for contraindications. The factors associated with potential drug-drug interactions were related to patient characteristics such as polypharmacy, age, comorbid disease, and hospital stay.Conclusions: There is a high prevalence of potential drug-drug interactions in Ethiopian hospitals. Polypharmacy, age, comorbid disease, and hospital stay were the risk factors associated with potential drug-drug interactions.

scholarly journals Effects of pharmacogenomic (PGx) testing on clinical pain management prescriptions, a retrospective study.

2021 ◽  
Author(s):  
Christian Tagwerker ◽  
Mary Jane Carias-Marines ◽  
David J. Smith
Keyword(s):  
Drug Interaction ◽  
Pain Management ◽  
Gene Interaction ◽  
Successful Implementation ◽  
Drug Classes ◽  
Clinical Pain ◽  
Progress Notes ◽  
Before And After ◽  
Drug Drug Interaction ◽  
And Training

Current deficits in effectively utilizing PGx testing in clinical practice include limited awareness and training of healthcare professionals, routine ordering of assays investigating up to 5 genes and lack of concise reporting of dosing guidelines and drug-drug-interactions. A novel deep sequencing (>1000X) PGx panel is described encompassing 23 genes and 141 SNPs or indels combined with PGx dosing guidance, drug-gene-interaction (DGI) and drug-drug-interaction (DDI) reporting to prevent adverse drug reaction events. During a 2-year period, patients (n = 171) were monitored in a pain management clinic. Urine toxicology, PGx reports, and progress notes were studied retrospectively for changes in prescription regimens before and after the PGx report was made available to the provider. Among patient PGx reports with medication lists provided (n = 146) 57.5% showed one or more moderate and 5.5% at least one serious pharmacogenetic interaction. 66% of patients showed at least one moderate and 15% one or more serious drug-gene or drug-drug-interaction. A significant number of active changes in prescriptions based on the PGx reports provided was observed for 85 patients (83%) for which a specific drug was either discontinued, switched within the defined drug classes of the report or a new drug added. Preventative action was observed for all serious interactions and only moderate interactions were tolerated for lack of other alternatives. This study demonstrates a successful implementation of PGx testing utilizing an extended PGx panel combined with a customized, informational report to help improve clinical outcomes.

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