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[Drug interactions in clinical practice. A pilot project for quality assurance in prescribing]
U Geppert1, W Beindl, T Hawranek
1Landesklinik für Dermatologie, Landeskliniken Salzburg, Salzburg, Austria.
Background And Objective:
The aim of the project was to document and evaluate the safety of combinations of drugs prescribed during hospitalization, producing a method of quality assurance assessment.
Patients/Methods:
The medications of 396 patients already taken at home as well as the drugs given in the hospital during an acute illness were analyzed. Potential drug interactions were detected using a computerized drug-interaction checking system i.e. Micromedex CD-ROM database DRUG-REAX. This program differentiates between contraindicated, major, moderate or minor interactions.
Results:
No contraindicated combinations of medications were found but in 265 instances (66,9%) potentially relevant ( major or moderate) combinations could be detected. There was a correlation between potentially dangerous drug combinations and the number of coadministered drugs. Despite the detection of a large number of potentially troublesome combinations, no significant clinical problems were observed over at least three days of observation.
Conclusions:
The number of potentially relevant drug interactions represents a severe problem in drug prescribing.