Join us   Log in  

PHARMASPIRE - Volume 12, Issue 4, October- December, 2020

Pages: 121-123

Date of Publication: 10-Jun-2022

Print Article   Download XML  Download PDF

Meaningful drug interaction alerts

Author: Simranjeet Kaur, Deepali Dhir, Sujata Kaundal, Amandeep Singh

Category: Pharmaceutics


Adverse drug reactions (ADRs) are the abnormal kind of the reaction which is associated with potential drug-drug interactions (DDIs) which further relate to so many side effects and the treatment failures. Studies have proven that with the aid of drug interaction alert systems, the medication error and potential adverse events can be reduced. DDIs are often implemented in the hospital computerized provider order entry (CPOE) with limited evaluation. Other strategies like clinical decision support (CDS) alert system is also applicable. It can be used along with the CPOE but they are associated with the alert fatigue problem arises when the physician overrides the alerts. In addition to this system, other computerized electronic databases and software’s system also exist. These meaningful alert strategies are important for both the physician and for the patient safety profile both for inpatient and outpatient. Physician can totally trust the computerized software alert programs as it is not easy for each and every physician to remember all the potential DDIs. Assessing the quality of DDI alerts depends on various studies but one of the better ways is to directly compare the results of two alert programs and then select the results according to the criteria required. Physicians do agreed to the point that due to the pop-up alerts, they are now more awarded about the potential drug interactions and some also feels that now they can prescribe the medication in much more safer manner.

Keywords: Adverse drug reactions, adverse drug events, drug interactions, clinical decision support, software


1. Meslin SM, Zheng WY, Day RO, Tay EM, Baysari MT. Evaluation of clinical relevance of drug-drug interaction alerts prior to implementation. Appl Clin Inform 2018;9:849-55.

2. Yeh ML, Chang YJ, Wang PY, Li YC, Hsu CY. Physicians’ responses to computerized drug-drug interaction alerts for outpatients. Comput Methods Programs Biomed 2013;111:17-25.

3. Slight SP, Seger DL, Nanji KC, Cho I, Maniam N, Dykes PC, et al. Are we heeding the warning signs? Examining providers’ overrides of computerized drug-drug interaction alerts in primary care. PLoS One 2013;8:e85071.

4. Wright A, McEvoy DS, Aaron S, McCoy AB, Amato MG, Kim H, et al. Structured override reasons for drug-drug interaction alerts in electronic health records. J Am Med Inform Assoc 2019;26:934-42.

5. Hussain MI, Reynolds TL, Zheng K. Medication safety alert fatigue may be reduced via interaction design and clinical role tailoring: A systematic review. J Am Med Inform Assoc 2019;26:1141-9.

6. McEvoy DS, Sittig DF, Hickman TT, Aaron S, Ai A, Amato M, et al. Variation in high-priority drug-drug interaction alerts across institutions and electronic health records. J Am Med Inform Assoc 2017;24:331-8.

7. Payne TH, Hines LE, Chan RC, Hartman S, Kapusnik-Uner J, Russ AL, et al. Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. J Am Med Inform Assoc 2015;22:1243-50.

8. Daniels CC, Burlison JD, Baker DK, Robertson J, Sablauer A, Flynn PM, et al. Optimizing drug-drug interaction alerts using a multidimensional approach. Pediatrics 2019;143:e20174111.

9. Cho I, Lee Y, Lee JH, Bates DW. Wide variation and patterns of physicians’ responses to drug-drug interaction alerts. Int J Qual Health Care 2019;31:89-95.

10. Bryant AD, Fletcher GS, Payne TH. Drug interaction alert override rates in the meaningful use era: No evidence of progress. Appl Clin Inform 2014;5:802-13.

11. Lowenstein D, Zheng WY, Burke R, Kenny E, Sandhu A, Makeham M, et al. Do user preferences align with human factors assessment scores of drug-drug interaction alerts? Health Inform J 2020;26:563-75.

12. Gatenby J, Blomqvist M, Burke R, Ritchie A, Gibson K, Patanwala AE. Adverse events targeted by drug-drug interaction alerts in hospitalized patients. Int J Med Inform 2020;143:104266.

13. Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: A systematic review. Arch Intern Med 2003;12:1409-16.

14. Kheshti R, Aalipour M, Namazi S. A comparison of five common drug-drug interaction software programs regarding accuracy and comprehensiveness. J Res Pharm Pract 2016;5:257-63.

15. Roblek T, Vaupotic T, Mrhar A, Lainscak M. Drug-drug interaction software in clinical practice: A systematic review. Eur J Clin Pharmacol 2015;71:131-42.