Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals

The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients’ medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction (DDI) checking based on a patient’s medication history stored in his/her NHI-IC card. For performance evaluation, we developed a transaction tracking log to keep track of every operation on NHI-IC cards. Based on analysis of the transaction tracking log from 1 August to 31 October 2007, physicians read patients’ NHI-IC cards in 71.01% (8,246) of patient visits; 33.02% (2,723) of the card reads showed at least one medicine currently being taken by the patient, 82.94% of which were prescribed during the last visit. Among 10,036 issued prescriptions, seven prescriptions (0.09%) contained at least one drug item that might interact with the currently-taken medicines stored in NHI-IC cards and triggered pop-up alerts. This study showed that the capacity of an NHI-IC card is adequate to support DDI checking across hospitals. Thus, the enhanced computerized physician order entry (CPOE) system can support better DDI checking when physicians are making prescriptions and provide safer medication care, particularly for patients who receive medication care from different hospitals.

[1]  D. Tatro,et al.  Comprar Drug Interaction Facts 2013 THE AUTHORITY ON DRUG INTERACTIONS | David S. Tatro | 9781574393415 | Lippincott Williams & Wilkins , 2012 .

[2]  Yu-Chuan Li,et al.  The use of a CPOE log for the analysis of physicians' behavior when responding to drug-duplication reminders , 2008, Int. J. Medical Informatics.

[3]  Alissa L. Russ,et al.  Prescribers' interactions with medication alerts at the point of prescribing: A multi-method, in situ investigation of the human-computer interaction , 2012, Int. J. Medical Informatics.

[4]  Patience B. Tetteh-Quarcoo,et al.  Self-Medication Practices with Antibiotics among Tertiary Level Students in Accra, Ghana: A Cross-Sectional Study , 2012, International journal of environmental research and public health.

[5]  D. Bates,et al.  Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. , 1998, JAMA.

[6]  Thomas H. Payne,et al.  Review Paper: Medication-related Clinical Decision Support in Computerized Provider Order Entry Systems: A Review , 2007, J. Am. Medical Informatics Assoc..

[7]  Yu-Chuan Li,et al.  Using Health Smart Cards to Check Drug Allergy History: The Perspective from Taiwan’s Experiences , 2011, Journal of Medical Systems.

[8]  Min-Huei Hsu,et al.  Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan , 2011, Int. J. Medical Informatics.

[9]  Chien-Tsai Liu,et al.  The impacts of smart cards on hospital information systems - An investigation of the first phase of the national health insurance smart card project in Taiwan , 2006, Int. J. Medical Informatics.

[10]  Wan-I Lee,et al.  The exploration of consumers' behavior in choosing hospital by the application of neural network , 2008, Expert Syst. Appl..

[11]  T K Hazlet,et al.  Performance of community pharmacy drug interaction software. , 2001, Journal of the American Pharmaceutical Association.

[12]  Robert D. McLeod,et al.  A mHealth Application for Chronic Wound Care: Findings of a User Trial , 2013, International journal of environmental research and public health.

[13]  C. Moura,et al.  Evaluation of drug–drug interaction screening software combined with pharmacist intervention , 2012, International Journal of Clinical Pharmacy.

[14]  Amy L. Seybert,et al.  Grading the Severity of Drug-Drug Interactions in the Intensive Care Unit: A Comparison Between Clinician Assessment and Proprietary Database Severity Rankings , 2010, The Annals of pharmacotherapy.

[15]  A. Laupacis,et al.  Drug-drug interactions among elderly patients hospitalized for drug toxicity. , 2003, JAMA.

[16]  D. Criddle,et al.  Comparative inhibitory effects of niflumic acid and novel synthetic derivatives on the rat isolated stomach fundus , 2002, The Journal of pharmacy and pharmacology.

[17]  Choung Hye-Uk,et al.  Personal Information Protection Act , 2011 .

[18]  Michelle A Chui,et al.  The role of pharmacy computer systems in preventing medication errors. , 2002, Journal of the American Pharmaceutical Association.

[19]  D. Leucuta,et al.  How many potential drug-drug interactions cause adverse drug reactions in hospitalized patients? , 2013, European journal of internal medicine.

[20]  Arie Oliven,et al.  Prevention of prescription errors by computerized, on-line surveillance of drug order entry , 2005, Int. J. Medical Informatics.

[21]  John R. Horn,et al.  Drug interactions analysis and management , 2011 .

[22]  Tzeng-Ji Chen,et al.  Patterns of ambulatory care utilization in Taiwan , 2006, BMC Health Services Research.

[23]  Bruce M. Greenwald,et al.  Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients. , 2008 .

[24]  Jolene Galegher,et al.  The Health Insurance Portability and Accountability Act Privacy Rule: A Practical Guide for Researchers , 2004, Medical care.

[25]  Anthony J Avery,et al.  Incidence and Possible Causes of Prescribing Potentially Hazardous/Contraindicated Drug Combinations in General Practice , 2005, Drug safety.

[26]  M. Takeichi,et al.  Second opinion behaviour among Japanese primary care patients. , 1999, The British journal of general practice : the journal of the Royal College of General Practitioners.

[27]  T. Fukui,et al.  Doctor-shopping patients and users of alternative medicine among Japanese primary care patients. , 1995, General hospital psychiatry.

[28]  G. J. Kuperman,et al.  Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, Burdick E, HicSheakey M, Kleefield SB, Vander Vliet M, Seger DL, Effect of computerized physician order entry and a team intervention on prevention of serious medication errors , 1999, Journal of Clinical Monitoring and Computing.

[29]  J. Forsström,et al.  Linking patient medication data with laboratory information system. , 1996, International journal of bio-medical computing.

[30]  P. Hansten,et al.  Drug interaction management , 2003, Pharmacy World and Science.

[31]  P. Glassman,et al.  Retrospective drug utilization review: incidence of clinically relevant potential drug-drug interactions in a large ambulatory population. , 2003, Journal of managed care pharmacy : JMCP.

[32]  Fong-Lin Jang,et al.  Patients’ Acceptance towards a Web-Based Personal Health Record System: An Empirical Study in Taiwan , 2013, International journal of environmental research and public health.

[33]  P. McDonnell,et al.  Hospital Admissions Resulting from Preventable Adverse Drug Reactions , 2002, The Annals of pharmacotherapy.

[34]  D. Craig.  Reduction of High‐Risk Polypharmacy Drug Combinations in Patients in a Managed Care Setting , 2006, Pharmacotherapy.

[35]  Yea-Huei Kao Yang,et al.  Classification of pharmaceutical products reimbursed by National Health Insurance by the ATC System , 2002 .

[36]  R K Spoeri,et al.  Polypharmacy management in Medicare managed care: changes in prescribing by primary care physicians resulting from a program promoting medication reviews. , 1999, The American journal of managed care.

[37]  David S. Tatro PharmD.  Drug Interaction Facts 2012: The Authority on Drug Interactions , 2012 .

[38]  Lisa Wang,et al.  Potential drug interactions and duplicate prescriptions among cancer patients. , 2007, Journal of the National Cancer Institute.

[39]  Shu-Ping Lin,et al.  Study on doctor shopping behavior: insight from patients with upper respiratory tract infection in Taiwan. , 2010, Health policy.

[40]  A. Hedley,et al.  Doctor-shopping in Hong Kong: implications for quality of care. , 1994, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[41]  B. Stricker,et al.  Hospitalisations and emergency department visits due to drug–drug interactions: a literature review , 2007, Pharmacoepidemiology and drug safety.

[42]  R. Lipton,et al.  Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions. , 2005, Journal of the American Pharmacists Association : JAPhA.