Management of drug interactions with beta-blockers: continuing education has a short-term impact

There is a lack of clear guidelines regarding the management of drug-drug interactions.

To assess the impact of an educational intervention on the management of drug interactions with beta-blockers.

The study had a controlled before-and-after design. The intervention group (n=10 pharmacies) received a continuing education course and guidelines on the management of drug interactions with beta-blockers. The control group (n=10 pharmacies) received no intervention. Pharmacy students and staff of internship pharmacies participated in this study. Before and after the intervention, students registered interactions with beta-blockers during two weeks. Information was obtained on drug information of the beta-blocker and the interacting drug, patient's demographics, and the mode of transaction.

A total number of 288 interactions were detected during both study periods. Most beta-blockers causing an interaction were prescribed for hypertension, and interacted with hypoglycemic agents, NSAIDs, or beta2-agonists. Pharmacists' intervention rate was low (14% in the pre-test compared to 39% in the post-test), but increased significantly in the post-test in the intervention group. Reasons for overriding the interaction included limited clinical relevance, refill prescriptions, not being aware of the interaction, and communication problems with the prescriber.

An interactive continuing education course, during which practice-oriented guidelines were offered, affected pharmacists' short-term behavior at the counter in dealing with interactions of beta-blockers. Continuing education plays a role in raising pharmacists' awareness and responsibility towards the detection and management of drug interactions in the pharmacy.