Evaluation of a drug-drug interaction: fax alert intervention program

Persistent Link:
http://hdl.handle.net/10150/610041
Title:
Evaluation of a drug-drug interaction: fax alert intervention program
Author:
Armstrong, Edward; Wang, Sharon; Hines, Lisa; Gao, Sara; Patel, Bimal; Malone, Daniel
Affiliation:
University of Arizona College of Pharmacy, 85721, Tucson, AZ, USA; MedImpact Healthcare Systems, Inc., San Diego, California, USA
Issue Date:
2013
Publisher:
BioMed Central
Citation:
Armstrong et al. BMC Medical Informatics and Decision Making 2013, 13:32 http://www.biomedcentral.com/1472-6947/13/32
Journal:
BMC Medical Informatics and Decision Making
Rights:
© 2013 Armstrong et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:Clinicians often encounter information about drug-drug interactions (DDIs) during clinical practice. This information is found within product information (hardcopy and electronic) and various electronic systems. Prescribers may receive medication-related communications in practice that are distributed by facsimile (fax), mail, or telephone from pharmacies and pharmacy benefit managers (PBMs). The purpose of this study was to determine if near-real time fax alerts for potential drug-drug interactions (PDDIs) would influence prescribing.METHODS:A prospective study, in cooperation with a pharmacy benefit manager (PBM), was conducted targeting 18 clinically important PDDIs. Fax alerts included an individualized letter to the prescriber with a list of the interacting drugs, PDDI evidence summaries with citations, and recommended clinical management strategies. Among the 18 PDDIs, 13 PDDIs could be assessed for prescription therapy changes using pharmacy claims data. A prospective cohort design was used to evaluate changes in prescription dispensing 90-days following a PDDI fax alert.RESULTS:A total of 8,075 fax alerts were sent to prescribers and there were 4,712 alerts for the 13 PDDIs that could be assessed for change using pharmacy claims data. There were 2,019 patients (interventions) for which fax alerts were sent to their prescribers who were matched with a control group consisting of patients with the same PDDIs but for whom no fax alert was sent. Overall, this study found 154 (7.6%) of patients in the fax alert group compared to 132 (6.5%) in the control group had changes in therapy (p=0.177).CONCLUSIONS:This fax alert intervention program observed no statistically significant differences in prescribing with a fax alert compared to the control group. If PBMs chose to send individualized, evidence-based information to clinicians regarding drug-drug interactions, this study suggests it may not be an effective intervention to mitigate harm.
EISSN:
1472-6947
DOI:
10.1186/1472-6947-13-32
Keywords:
Drug interactions; Drug safety; Physician; Prescriber; Fax
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1472-6947/13/32

Full metadata record

DC FieldValue Language
dc.contributor.authorArmstrong, Edwarden
dc.contributor.authorWang, Sharonen
dc.contributor.authorHines, Lisaen
dc.contributor.authorGao, Saraen
dc.contributor.authorPatel, Bimalen
dc.contributor.authorMalone, Danielen
dc.date.accessioned2016-05-20T08:57:12Z-
dc.date.available2016-05-20T08:57:12Z-
dc.date.issued2013en
dc.identifier.citationArmstrong et al. BMC Medical Informatics and Decision Making 2013, 13:32 http://www.biomedcentral.com/1472-6947/13/32en
dc.identifier.doi10.1186/1472-6947-13-32en
dc.identifier.urihttp://hdl.handle.net/10150/610041-
dc.description.abstractBACKGROUND:Clinicians often encounter information about drug-drug interactions (DDIs) during clinical practice. This information is found within product information (hardcopy and electronic) and various electronic systems. Prescribers may receive medication-related communications in practice that are distributed by facsimile (fax), mail, or telephone from pharmacies and pharmacy benefit managers (PBMs). The purpose of this study was to determine if near-real time fax alerts for potential drug-drug interactions (PDDIs) would influence prescribing.METHODS:A prospective study, in cooperation with a pharmacy benefit manager (PBM), was conducted targeting 18 clinically important PDDIs. Fax alerts included an individualized letter to the prescriber with a list of the interacting drugs, PDDI evidence summaries with citations, and recommended clinical management strategies. Among the 18 PDDIs, 13 PDDIs could be assessed for prescription therapy changes using pharmacy claims data. A prospective cohort design was used to evaluate changes in prescription dispensing 90-days following a PDDI fax alert.RESULTS:A total of 8,075 fax alerts were sent to prescribers and there were 4,712 alerts for the 13 PDDIs that could be assessed for change using pharmacy claims data. There were 2,019 patients (interventions) for which fax alerts were sent to their prescribers who were matched with a control group consisting of patients with the same PDDIs but for whom no fax alert was sent. Overall, this study found 154 (7.6%) of patients in the fax alert group compared to 132 (6.5%) in the control group had changes in therapy (p=0.177).CONCLUSIONS:This fax alert intervention program observed no statistically significant differences in prescribing with a fax alert compared to the control group. If PBMs chose to send individualized, evidence-based information to clinicians regarding drug-drug interactions, this study suggests it may not be an effective intervention to mitigate harm.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1472-6947/13/32en
dc.rights© 2013 Armstrong et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectDrug interactionsen
dc.subjectDrug safetyen
dc.subjectPhysicianen
dc.subjectPrescriberen
dc.subjectFaxen
dc.titleEvaluation of a drug-drug interaction: fax alert intervention programen
dc.typeArticleen
dc.identifier.eissn1472-6947en
dc.contributor.departmentUniversity of Arizona College of Pharmacy, 85721, Tucson, AZ, USAen
dc.contributor.departmentMedImpact Healthcare Systems, Inc., San Diego, California, USAen
dc.identifier.journalBMC Medical Informatics and Decision Makingen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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