Roblek Tina, Vaupotic Tomaz, Mrhar Ales, Lainscak Mitja
Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
Eur J Clin Pharmacol. 2015 Feb;71(2):131-42. doi: 10.1007/s00228-014-1786-7. Epub 2014 Dec 23.
Several electronic databases which report the prevalence of drug-drug interactions (DDIs) are used as a tool for evaluation of potentially harmful DDIs. The aim of our review was to evaluate the usability and appropriateness of commercially available electronic databases which assess the prevalence of potential DDIs.
The systematic electronic literature search was conducted with the following search terms: "database" AND "software," and "drug-drug interactions" AND "database," and the inclusion and exclusion criteria were applied in order to identify the publications of interest.
A total of 3766 papers were identified by systematic search. After applying inclusion and exclusion criteria, 38 publications were included in the analysis. The most commonly used software in the included studies was Micromedex® Drug-Reax, for which some authors argue to be the most reliable due to highest sensitivity. It gives information about clinical consequences of DDIs, classifies underlying mechanism and onset of the adverse outcome (either rapid, or delayed) as well as severity (such as minor, moderate, or major), and provides the level of evidence which supports this information. This data is also provided by Drug Interaction Facts®, Lexi-Interact®, and Pharmavista®. A small number of studies which compared assessment of DDIs with electronic database and the clinician's assessment showed large discrepancy in number and relevance of detected DDIs. The overlap was in some cases as low as 11 %.
The deficiency of clinical relevance of detected DDIs should be addressed in the upcoming research as it would provide more relevant information to the prescribers' in clinical practice.
几个报告药物相互作用（DDIs）发生率的电子数据库被用作评估潜在有害药物相互作用的工具。我们综述的目的是评估可商购的用于评估潜在药物相互作用发生率的电子数据库的可用性和适用性。
使用以下检索词进行系统的电子文献检索：“数据库”和“软件”，以及“药物相互作用”和“数据库”，并应用纳入和排除标准以识别感兴趣的出版物。
通过系统检索共识别出3766篇论文。应用纳入和排除标准后，38篇出版物被纳入分析。纳入研究中最常用的软件是Micromedex® Drug-Reax，一些作者认为由于其最高的敏感性，它是最可靠的。它提供有关药物相互作用临床后果的信息，对潜在机制和不良后果的发生（快速或延迟）以及严重程度（如轻微、中度或重度）进行分类，并提供支持该信息的证据水平。Drug Interaction Facts®、Lexi-Interact®和Pharmavista®也提供此数据。少数将电子数据库对药物相互作用的评估与临床医生的评估进行比较的研究表明，检测到的药物相互作用在数量和相关性方面存在很大差异。在某些情况下，重叠率低至11%。
在未来的研究中应解决检测到的药物相互作用临床相关性不足的问题，因为这将为临床实践中的开处方者提供更相关的信息。
