Agreement of Different Drug-Drug Interaction Checkers for Proton Pump Inhibitors

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Drug Safety

Background:

• Proton pump inhibitors (PPIs) are frequently prescribed, leading to potential drug-drug interactions (DDIs), especially in elderly patients with multiple conditions.
• Summary of Product Characteristics (SPCs) and interaction checkers (ICs) are used to identify and manage these DDIs.

Purpose of the Study:

• To evaluate the consistency of information regarding PPI-related DDIs across SPCs and various ICs.
• To assess the agreement in identifying interacting drugs and classifying DDI severity.

Main Methods:

• A cross-sectional study analyzed data from 5 PPIs and 5 ICs.
• Information was extracted and compared to assess agreement using Gwet AC1, Cohen κ, and Fleiss κ statistics.

Main Results:

• SPCs identified significantly fewer interacting drugs compared to ICs.
• The overall agreement among the 5 ICs for identifying potential PPI interactions was poor (Gwet AC1 range: 0.23-0.27).
• Agreement remained low even when focusing on severe DDIs.

Conclusions:

• Significant disagreement exists between ICs and SPCs regarding PPI-DDIs.
• Standardization of DDI databases is needed.
• Clinicians should use multiple ICs and consult specialists for complex cases to ensure accurate DDI evaluation and prevention.