PDF(Pubmed)
Abstract：
Background: Toxicity or treatment failure related to drug-drug interactions (DDIs) are known to significantly affect morbidity and hospitalization rates. Despite the availability of numerous databases for DDIs identification and management, their information often differs. Oral anticoagulants are deemed at risk of DDIs and a leading cause of adverse drug events, most of which being preventable. Although many databases include DDIs involving anticoagulants, none are specialized in them. Aim and method: This study aims to compare the DDIs information content of four direct oral anticoagulants and two vitamin K antagonists in three major DDI databases used in Switzerland: Lexi-Interact, Pharmavista, and MediQ. It evaluates the consistency of DDIs information in terms of differences in severity rating systems, mechanism of interaction, extraction and documentation processes and transparency. Results: This study revealed 2\'496 DDIs for the six anticoagulants, with discrepant risk classifications. Only 13.2% of DDIs were common to all three databases. Overall concordance in risk classification (high, moderate, and low risk) was slight (Fleiss\' kappa = 0.131), while high-risk DDIs demonstrated a fair agreement (Fleiss\' kappa = 0.398). The nature and the mechanism of the DDIs were more consistent across databases. Qualitative assessments highlighted differences in the documentation process and transparency, and similarities for availability of risk classification and references. Discussion: This study highlights the discrepancies between three commonly used DDI databases and the inconsistency in how terminology is standardised and incorporated when classifying these DDIs. It also highlights the need for the creation of specialised tools for anticoagulant-related interactions.
摘要：
背景：已知与药物-药物相互作用（DDI）相关的毒性或治疗失败会显著影响发病率和住院率。尽管有许多用于DDI识别和管理的数据库，他们的信息经常不同。口服抗凝剂被认为有DDI的风险，也是导致药物不良事件的主要原因。其中大部分是可以预防的。尽管许多数据库包括涉及抗凝剂的DDI，没有一个是专门的。目的和方法：本研究旨在比较瑞士使用的三个主要DDI数据库中四种直接口服抗凝剂和两种维生素K拮抗剂的DDI信息含量：Lexi-Interact，Pharmavista,MediQ。它根据严重性评级系统的差异评估DDI信息的一致性，相互作用机制，提取和文档过程和透明度。结果：这项研究揭示了6种抗凝剂的2'496DDIs，具有不同的风险分类。在所有三个数据库中，只有13.2%的DDI是共同的。风险分类的总体一致性(高，中度,和低风险)轻微(Fleiss\'kappa=0.131)，而高风险DDI表现出公平的协议(Fleiss\'kappa=0.398)。DDI的性质和机制在数据库中更加一致。定性评估强调了文件编制过程和透明度方面的差异，以及风险分类和参考文献可用性的相似性。讨论：本研究强调了三个常用DDI数据库之间的差异，以及在对这些DDI进行分类时如何标准化和合并术语的不一致。它还强调了创建抗凝剂相关相互作用的专用工具的必要性。
