Performance of community pharmacy drug interaction software.

OBJECTIVE

To evaluate the performance of computerized drug-drug interaction (DDI) software in identifying clinically important drug-drug interactions.

DESIGN

One-time performance test of computer systems using a standard set of prescriptions.

SETTING

Community pharmacies or central corporate locations with pharmacy terminals identical to those used in actual pharmacies.

PARTICIPANTS

Chain and health maintenance organization (HMO) pharmacies with seven or more practice sites in Washington State. A total of nine different DDI software programs were installed in 516 community pharmacies represented by these chains and HMOs.

MAIN OUTCOME MEASURES

Sensitivity, specificity, and positive and negative predictive values of software in detecting 16 well-established DDIs contained within six fictitious patient profiles.

RESULTS

The software systems failed to detect clinically relevant DDIs one-third of the time. Sensitivity of the software programs ranged from 0.44 to 0.88, with 1.00 being perfect; specificity ranged from 0.71 to 1.00; positive predictive value ranged from 0.67 to 1.00; and negative predictive value ranged from 0.69 to 0.90. For software packages that were installed at different locations, between-installation differences were observed.

CONCLUSION

The performance of most DDI-detecting software programs tested in this study was suboptimal. Improvement is needed to advance their contribution to detection of DDIs.