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Management of drug-interaction alerts in community pharmacies
J Indermitte1, M Beutler, R Bruppacher
1Department of Pharmaceutical Sciences, Institute of Clinical Pharmacy, University of Basel, Basel, Switzerland.
Journal of Clinical Pharmacy and Therapeutics
|March 27, 2007
Summary
Community pharmacy drug-interaction alert systems often lead to overrides, especially for less severe interactions. Pharmacists may adjust settings to flag only high-severity alerts, but severe interactions are generally managed effectively.
Area of Science:
- Pharmacology
- Health Informatics
- Community Pharmacy Practice
Background:
- Drug-interaction alert systems are crucial in community pharmacies for identifying potential drug-drug interactions.
- Overriding alerts due to excessive notifications is a common issue influenced by software default settings.
Purpose of the Study:
- To investigate how community pharmacies in Switzerland handle drug-interaction alerts.
- To understand the factors influencing the override of these alerts by pharmacists.
Main Methods:
- Data collection involved 15 pharmacy students across 15 Swiss community pharmacies.
- Assessed medication histories and drug-interaction alerts for 600 patients with multiple prescriptions.
- Conducted interviews with pharmacists regarding their management of drug-interaction alerts.
Main Results:
- Alert system severity settings varied, impacting alert frequency.
- A significant proportion of alerts (71.9%) were overridden by default settings or pharmacists.
- Pharmacists intervened in 63.2% of closely examined relevant alerts, with high severity and first-time alerts being key determinants.
Conclusions:
- Pharmacists frequently override alerts for minor/moderate severity interactions or adjust systems to prioritize high-severity ones.
- There is a need for more sophisticated alert systems with better sensitivity and specificity.
- Current systems largely succeed in ensuring severe drug interactions are not missed.
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