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

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    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
    Keywords
    Drug interactions
    Drug safety
    Physician
    Prescriber
    Fax
    
    Metadata
    Show full item record
    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
    Version
    Final published version
    Additional Links
    http://www.biomedcentral.com/1472-6947/13/32
    ae974a485f413a2113503eed53cd6c53
    10.1186/1472-6947-13-32
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    UA Faculty Publications

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