Early detection of drug interactions utilizing a computerized drug prescription handling system-focus on cerivastatin-gemfibrozil.
OBJECTIVE
Based on the recent cerivastatin experience, we retrospectively evaluated the effect of notifying a drug alert utilizing a computerized drug-handling system.


METHODS
The evaluation was carried out during three periods: period I corresponded to all prescriptions issued during April, 2001 ("baseline period"), before the Spanish Drug Agency issued alerts on the concomitant therapy with cerivastatin and gemfibrozil; period II (June) corresponded to a time in which a first informative note had been released; and period III (July) after the second warning alert was issued.


RESULTS
Data collected included the reading of 2,693,656 drug prescriptions, 1,937,083 (71.9%) of which contained patient information. Forty-four patients received combined therapy with cerivastatin and gemfibrozil over the three periods, yielding 55 exposures: 27 during the baseline period, and 28 between periods II and III, when the alert bulletins had already been released. Moreover, 41.6% of doctors included in the follow-up repeated the hazardous prescription during those two periods.


CONCLUSIONS
The effect of the informative notes about the risk of prescribing cerivastatin and gemfibrozil concomitantly on doctors' prescribing habits was limited. The system for screening information from drug prescriptions presented herein allows the early detection of drug interactions by identifying the doctors who issue hazardous prescriptions as well as patients at the highest risk of adverse drug reactions, thus allowing a personal feedback with both of them.
Morera
Tomás
T
Drug Surveillance Center of Extremadura, Department of Pharmacology, Medical School, University of Extremadura, Avenida de Elvas, 06071 Badajoz, Spain.
Gervasini
Guillermo
G
Carrillo
Juan A
JA
Benitez
Julio
J
D004347:Drug Interactions; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D015248:Gemfibrozil / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D016347:Medical Records Systems, Computerized; D010818:Practice Patterns, Physicians'; D011725:Pyridines / Q000009:adverse effects*; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000139:chemically induced; D013030:Spain
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011725:Pyridines; C086276:cerivastatin; D015248:Gemfibrozil