Pharmacoepidemiology and Prescription

European Journal of Clinical Pharmacology

, Volume 69, Issue 3, pp 565-571

First online:

Impact of the drug-drug interaction database SFINX on prevalence of potentially serious drug-drug interactions in primary health care

  • M. L. AnderssonAffiliated withDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska Institutet Email author 
  • , Y. BöttigerAffiliated withDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska Institutet
  • , J. D. LindhAffiliated withDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska Institutet
  • , B. WettermarkAffiliated withDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska InstitutetPublic Healthcare Services Committee, Stockholm County Council
  • , B. EiermannAffiliated withDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska Institutet

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Abstract

Purpose

To investigate the impact of the integration of the drug-drug interaction database SFINX into primary health care records on the prevalence of potentially serious drug-drug interactions.

Methods

The study was a controlled before-and-after study on the prevalence of potential drug-drug interactions before and after the implementation of SFINX at 15 primary healthcare centres compared with 5 centres not receiving the intervention. Data on dispensed prescriptions from health care centres were retrieved from the Swedish prescribed drug register and analysed for September–December 2006 (pre-intervention) and September–December 2007 (post-intervention). All drugs dispensed during each 4 month period were regarded as potentially interacting.

Results

Use of SFINX was associated with a 17% decrease, to 1.81 × 10−3 from 2.15 × 10−3 interactions per prescribed drug-drug pair, in the prevalence of potentially serious drug-drug interactions (p = 0.042), whereas no significant effect was observed in the control group. The change in prevalence of potentially serious drug-drug interactions did not differ significantly between the two study groups. The majority of drug-drug interactions identified were related to chelate formation.

Conclusion

Prescriptions resulting in potentially serious drug-drug interactions were significantly reduced after integration of the drug-drug interaction database SFINX into electronic health records in primary care. Further studies are needed to demonstrate the effectiveness of drug-drug interaction warning systems.

Keywords

Drug-drug interactions Clinical decision support systems Database management systems Medical order entry systems Medication errors/prevention and control