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The value of software that provides clinically relevant information on drug interactions

  • Author Footnotes
    1 Contributed equally to the work.
    Stefania Antoniazzi
    Footnotes
    1 Contributed equally to the work.
    Affiliations
    Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital “Luigi Sacco”, Università di Milano, Via GB Grassi 74, 20157 Milan, Italy

    Scientific Direction, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, via Francesco Sforza 28, 20122 Milan, Italy
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  • Author Footnotes
    1 Contributed equally to the work.
    Maria Teresa Chiarelli
    Footnotes
    1 Contributed equally to the work.
    Affiliations
    Hospital PharmacyDepartment, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, 20122 Milan, Italy
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  • Alessandro Nobili
    Affiliations
    IRCCS—Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, 20156 Milan, Italy
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  • Luca Pasina
    Correspondence
    Corresponding author at: Pharmacotherapy and Appropriateness of Drugs Prescription Unit, IRCCS, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa, 19, 20156 Milano, Italy. Tel.: +39 02 39014 579; fax: +39 02 39001916.
    Affiliations
    IRCCS—Istituto di Ricerche Farmacologiche “Mario Negri”, via Giuseppe La Masa 19, 20156 Milan, Italy
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  • Francesca Venturini
    Affiliations
    Hospital PharmacyDepartment, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, 20122 Milan, Italy
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  • Author Footnotes
    1 Contributed equally to the work.
      Potential drug–drug interactions (pDDIs) are critical issues in the management of the elderly. The development of multiple diseases with increasing age leads to therapies based upon many concomitant drugs, a risk factor for severe pDDIs [
      • Nobili A.
      • Pasina L.
      • Tettamanti M.
      • Lucca U.
      • Riva E.
      • Marzona I.
      • et al.
      Potentially severe drug interactions in elderly outpatients: results of an observational study of an administrative prescription database.
      ]. Pharmacological interactions may affect patient health by leading to adverse drug reactions and more hospitalisations [
      • Becker M.L.
      • Kallewaard M.
      • Caspers P.W.
      • Visser L.E.
      • Leufkens H.G.
      • Stricker B.H.
      Hospitalisations and emergency department visits due to drug–drug interactions: a literature review.
      ,
      • Hamilton R.A.
      • Briceland L.L.
      • Andritz M.H.
      Frequency of hospitalization after exposure to known drug–drug interactions in a Medicaid population.
      ,
      • Marengoni A.
      • Pasina L.
      • Concoreggi C.
      • Martini G.
      • Brognoli F.
      • Nobili A.
      • et al.
      Understanding adverse drug reactions in older adults through drug–drug interactions.
      ], so that they also represent a cost for the healthcare systems [
      • Moura C.S.
      • Acurcio F.A.
      • Belo N.O.
      Drug–drug interactions associated with length of stay and cost of hospitalization.
      ]. In order to minimise pDDIs and assist clinicians with information readily available at the time of prescription, the computerised prescription support system (CPSS) INTERCheck® was developed by the IRCCS Istituto di Ricerche Mario Negri of Milan. This software provides a list of pDDIs associated to drug therapies, classifying them according to their clinical relevance: D means contraindicated (drug combinations should be avoided); C, major DDIs (drug combinations requiring close monitoring for potentially serious clinical consequences, such as severe adverse effects or lack of clinical efficacy); B, moderate (drug combinations requiring dose adjustment and/or drug concentration monitoring); A, minor (drug combinations with no known clinical relevance). INTERCheck® was already validated in the frame of clinical practice [
      • Ghibelli S.
      • Marengoni A.
      • Djade C.D.
      • Nobili A.
      • Tettamanti M.
      • Franchi C.
      • et al.
      Prevention of inappropriate prescribing in hospitalized older patients using a computerized prescription support system (INTERcheck(®)).
      ], confirming its effectiveness in reducing potentially severe pDDIs. However, the correlation between the clinical relevance of pDDIs as detected by this software and clinician's personal judgement was not investigated until now.

      Keywords

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