title: Incidence rate and pattern of clinically relevant potential drug-drug interactions in a large outpatient population of a developing country.
abstract: The objective of this study was to determine incidence rate, type, and pattern of clinically relevant potential drug-drug interactions (pDDIs) in a large outpatient population of a developing country. A retrospective, descriptive cross-sectional study was conducted on outpatients' prescriptions in Khorasan Razavi province, Iran, over 12 months. A list of 25 clinically relevant DDIs, which are likely to occur in the outpatient setting, was used as the reference. Most frequent clinically relevant pDDIs, most common drugs contributing to the pDDIs, and the pattern of pDDIs for each medical specialty were determined. Descriptive statistics were used to report the results. In total, out of 8,169,142 prescriptions, 6,096 clinically relevant pDDIs were identified. The most common identified pDDIs were theophyllines-quinolones, warfarin-nonsteroidal anti-inflammatory drugs, benzodiazepines-azole antifungal agents, and anticoagulants-thyroid hormones. The most common drugs contributing to the identified pDDIs were ciprofloxacin, theophylline, warfarin, aminophylline, alprazolam, levothyroxine, and selegiline. While the incidence rate of clinically relevant pDDIs in prescriptions of general practitioners, internists, and cardiologists was the highest, the average pDDI incidence per 10,000 prescriptions of pulmonologists, infectious disease specialists, and cardiologists was highest. Although a small proportion of the analyzed prescriptions contained drug pairs with potential for clinically relevant DDIs, a significant number of outpatients have been exposed to the adverse effects associated with these interactions. It is recommended that in addition to training physicians and pharmacists, other effective interventions such as computerized alerting systems and electronic prescribing systems be designed and implemented.
authors: Student Research Committee, Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
authors: Ehsan
authors: E
authors: Nabovati
authors: Student Research Committee, Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
authors: Hasan
authors: H
authors: Vakili-Arki
authors: Targeted Drug Delivery Research Center and Neurogenic Inflammation Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
authors: Zhila
authors: Z
authors: Taherzadeh
authors: Medical Chemistry Department, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
authors: Mohammad Reza
authors: MR
authors: Saberi
authors: Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Ameen
authors: A
authors: Abu-Hanna
authors: Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.
authors: Saeid
authors: S
authors: Eslami
keywords: Developing countries; Drug utilization review; Drug-drug interactions; Patient safety