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Clinical Utility of Definitive Drug–Drug Interaction Testing in Primary Care

1
Department of Epidemiology and Biostatistics/Department of Medicine, University of California, San Francisco, CA 94158, USA
2
School of Public Health, University of California, Los Angeles, CA 90095, USA
3
QURE Healthcare, San Francisco, CA 94133, USA
4
Aegis Sciences Corporation, Nashville, TN 37228, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(11), 384; https://doi.org/10.3390/jcm7110384
Received: 3 October 2018 / Revised: 19 October 2018 / Accepted: 22 October 2018 / Published: 25 October 2018
(This article belongs to the Section Epidemiology & Public Health)
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PDF [210 KB, uploaded 25 October 2018]

Abstract

Drug–drug interactions (DDIs) are a leading cause of morbidity and mortality. New tools are needed to improve identification and treatment of DDIs. We conducted a randomized controlled trial to assess the clinical utility of a new test to identify DDIs and improve their management. Primary care physicians (PCPs) cared for simulated patients presenting with DDI symptoms from commonly prescribed medications and other ingestants. All physicians, in either control or one of two intervention groups, cared for six patients over two rounds of assessment. Intervention physicians were educated on the DDI test and given access to these test reports when caring for their patients in the second round. At baseline, we saw no significant differences in making the DDI diagnosis (p = 0.071) or DDI-related treatment (p = 0.640) between control and intervention arms. By round two, providers who accessed the DDI test performed significantly better in making the DDI diagnosis (+41.6%) and performing DDI-specific treatment (+12.2%) than in the previous round, and were 9.8 and 20.4 times more likely to diagnose and identify the DDI (p < 0.001 for all). The introduction of a definitive DDI test significantly increased identification, appropriate management, and counseling of DDIs among PCPs, which has the potential to improve clinical care. View Full-Text
Keywords: drug–drug interaction; drug–food interaction; drug–supplement interaction; medication reconciliation; adverse drug event; primary care; psychiatric medications; CNS depressants; opioids drug–drug interaction; drug–food interaction; drug–supplement interaction; medication reconciliation; adverse drug event; primary care; psychiatric medications; CNS depressants; opioids
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Peabody, J.; Tran, M.; Paculdo, D.; Schrecker, J.; Valdenor, C.; Jeter, E. Clinical Utility of Definitive Drug–Drug Interaction Testing in Primary Care. J. Clin. Med. 2018, 7, 384.

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