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Management of drug-disease interactions: a best practice from the Netherlands

International Journal of Clinical Pharmacy volume 43, pages 1437–1450 (2021)Cite this article

Abstract

Background Drug-disease interactions are situations where pharmacotherapy may have a negative effect on patients’ comorbidities. In these cases, it can be necessary to avoid that drug, adjust its dose or monitor therapy. In the Netherlands, pharmacists have developed a best practice how to systematically evaluate drug-disease interactions based on pharmacological considerations and implement recommendations for specific drug-disease interactions. Aim To describe the development of recommendations for drug-disease interactions and the implementation in prescribing and dispensing practice in the Netherlands. Setting Pharmacies and physicians’ practices in primary care and hospitals in the Netherlands. Development A multi-disciplinary expert panel assessed if diseases had clinically relevant drug-disease interactions and evaluated drug-disease interactions by literature review and expert opinion, and subsequently developed practice recommendations. Implementation The recommendations were implemented in all clinical decision support systems in primary care and hospitals throughout the Netherlands. Evaluation Recommendations were developed for 57 diseases and conditions. Cardiovascular diseases have the most drug-disease interactions (n = 12, e.g. long QT-syndrome, heart failure), followed by conditions related to the reproductive system (n = 7, e.g. pregnancy). The number of drugs with recommendations differed between 6 for endometriosis and tympanostomy tubes, and up to 1171 in the case of porphyria or even all drugs for pregnancy. Conclusion Practice recommendations for drug-disease interactions were developed, and implemented in prescribing and dispensing practice. These recommendations support both pharmacists and physicians by signalling clinically relevant drug-disease interactions at point of care, thereby improving medication safety. This practice may be adopted and contribute to safer medication use in other countries as well.

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Authors and Affiliations

  1. Department of Clinical Decision Support, Health Base Foundation, Papiermolen 36, 3994DK, Houten, the Netherlands

    Maaike M. E. Diesveld, Suzanne de Klerk & Sander D. Borgsteede

  2. Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

    Pieter Cornu

  3. Department of Medical Informatics, UZ Brussel, Brussels, Belgium

    Pieter Cornu

  4. Hospital Pharmacy and Doctoral Programme Clinical Pharmacy, University Hospital Munich, Munich, Germany

    Dorothea Strobach

  5. Department of Pharmacy, Unit of Pharmacotherapy, Epidemiology and Economics, University of Groningen, Groningen, the Netherlands

    Katja Taxis

Authors
  1. Maaike M. E. Diesveld
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  2. Suzanne de Klerk
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  3. Pieter Cornu
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  4. Dorothea Strobach
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  6. Sander D. Borgsteede
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Correspondence to Sander D. Borgsteede.

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Conflicts of interest

Maaike M. E. Diesveld, Suzanne de Klerk and Sander D. Borgsteede are employed at Health Base Foundation (HBF), an independent, non-commercial foundation that maintains a drug information database (Pharmabase) and supports health care professional with a clinical decision support system. The drug-disease interactions studied in this manuscript are subject to medical information provided by HBF.

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Diesveld, M.M.E., de Klerk, S., Cornu, P. et al. Management of drug-disease interactions: a best practice from the Netherlands. Int J Clin Pharm 43, 1437–1450 (2021). https://doi.org/10.1007/s11096-021-01308-0

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