Medication control in hospitals: a practical approach to the problem of drug-drug interactions.

An important task of pharmacists is medication control by screening the medication of an individual patient. Many computerized drug interaction screening programs are available, but they all have their drawbacks. Screening without a computerized program is possible, but very time-consuming. In contrast to daily living at home, the patient in a hospital setting is carefully monitored and relevant biochemical parameters are regularly checked. Many potential drug interactions are countered immediately by changing (dosage of) medication. The aim of our study was to determine the number of drug-drug interactions and (pseudo)double medications on the internal, pulmonary and cardiological ward in order to discuss them with the physicians. During this discussion the clinical relevance of interactions was determined. We conclude that the number of clinically relevant interactions and (pseudo)double medication is limited, but that the role of the pharmacist is an important one, especially with regard to medication, that is not regularly used on a ward. Potential drug interactions should be predicted and dealt with by close teamwork of physician and pharmacist at the moment medication is prescribed.