title: Comparative evaluation of the drug interaction screening programs MediQ and ID PHARMA CHECK in neurological inpatients.
abstract: OBJECTIVE
  The comparative evaluation of clinical decision support software (CDSS) programs regarding their sensitivity and positive predictive value for the identification of clinically relevant drug interactions.
  
  
  METHODS
  In this research, we used a cross-sectional study that identified potential drug interactions using the CDSS MediQ and the ID PHARMA CHECK in 484 neurological inpatients. Interactions were reclassified according to the Zurich Interaction System, a multidimensional classification that incorporates the Operational Classification of Drug Interactions.
  
  
  RESULTS
  In 484 patients with 2812 prescriptions, MediQ and ID PHARMA CHECK generated a total of 1759 and 1082 alerts, respectively. MediQ identified 658 unique potentially interacting combinations, 8 classified as "high danger," 164 as "average danger," and 486 as "low danger." ID PHARMA CHECK detected 336 combinations assigned to one or several of 12 risk and management categories. Altogether, both CDSS issued alerts relating to 808 unique potentially interacting combinations. According to the Zurich Interaction System, 6 of these were contraindicated, 25 were provisionally contraindicated, 190 carried a conditional risk, and 587 had a minimal risk of adverse events. The positive predictive value for alerts having at least a conditional risk was 0.24 for MediQ and 0.48 for ID PHARMA CHECK.
  
  
  CONCLUSIONS
  CDSS showed major differences in the identification and grading of interactions, and many interactions were only identified by one of the two CDSS. For both programs, only a small proportion of all identified interactions appeared clinically relevant, and the selected display of alerts that imply management changes is a key issue in the further development and local setup of such programs.
authors.affiliation: Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Olesya I
authors.initials: OI
authors.lastname: Zorina
authors.forename: Patrick
authors.initials: P
authors.lastname: Haueis
authors.forename: Alexander
authors.initials: A
authors.lastname: Semmler
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marti
authors.forename: Roman R
authors.initials: RR
authors.lastname: Gonzenbach
authors.forename: Markus
authors.initials: M
authors.lastname: Guzek
authors.forename: Gerd A
authors.initials: GA
authors.lastname: Kullak-Ublick
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.forename: Stefan
authors.initials: S
authors.lastname: Russmann
mesh_terms: D002491:Central Nervous System Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D004347:Drug Interactions; D006801:Humans; D007297:Inpatients; D008403:Mass Screening / Q000379:methods*; D018570:Risk Assessment
chemical_list: D002491:Central Nervous System Agents