title: Consensus recommendations for systematic evaluation of drug-drug interaction evidence for clinical decision support.
abstract: BACKGROUND
  Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations.
  
  
  OBJECTIVE
  The aim of this study was to provide recommendations for systematic evaluation of evidence for DDIs from the scientific literature, drug product labeling, and regulatory documents.
  
  
  METHODS
  A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 18 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar 12 times from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations.
  
  
  RESULTS
  We developed expert consensus answers to the following three key questions. (i) What is the best approach to evaluate DDI evidence? (ii) What evidence is required for a DDI to be applicable to an entire class of drugs? (iii) How should a structured evaluation process be vetted and validated?
  
  
  CONCLUSIONS
  Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug compendia and clinical decision support systems in which these recommendations are implemented should be able to provide higher-quality information about DDIs.
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Scheife
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Hines
authors.forename: Richard D
authors.initials: RD
authors.lastname: Boyce
authors.forename: Sophie P
authors.initials: SP
authors.lastname: Chung
authors.forename: Jeremiah D
authors.initials: JD
authors.lastname: Momper
authors.forename: Christine D
authors.initials: CD
authors.lastname: Sommer
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Abernethy
authors.forename: John R
authors.initials: JR
authors.lastname: Horn
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sklar
authors.forename: Samantha K
authors.initials: SK
authors.lastname: Wong
authors.forename: Gretchen
authors.initials: G
authors.lastname: Jones
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brown
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Grizzle
authors.forename: Susan
authors.initials: S
authors.lastname: Comes
authors.forename: Tricia Lee
authors.initials: TL
authors.lastname: Wilkins
authors.forename: Clarissa
authors.initials: C
authors.lastname: Borst
authors.forename: Michael A
authors.initials: MA
authors.lastname: Wittie
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Malone
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards*; D016208:Databases, Factual; D020000:Decision Support Systems, Clinical / Q000592:standards*; D004347:Drug Interactions; D004348:Drug Labeling; D055695:Electronic Prescribing; D019317:Evidence-Based Medicine / Q000592:standards*; D017410:Practice Guidelines as Topic