Abstract：
OBJECTIVE: Several drug-drug interaction (DDI) checkers such as DDI-Predictor have been developed to detect and grade DDIs. DDI-Predictor gives an estimate of the magnitude of an interaction based on the ratio of areas under the curve. The objective of the present study was to analyse the frequencies of DDIs involving well-known strong interactors such as rifampicin and selective serotonin reuptake inhibitors (SSRIs), as reported by a clinical pharmacy team using DDI-Predictor, and the pharmacist intervention acceptance rate.
METHODS: The pharmacist intervention rate and the physician acceptance rate were calculated for DDIs involving rifampicin or the SSRIs fluoxetine, paroxetine, duloxetine and sertraline. The rates were compared with a bilateral χ2 test or Fisher\'s exact test.
RESULTS: Of the 284 DDIs recorded, 38 (13.4%) involved rifampicin and 78 (27.5%) involved SSRIs. The pharmacist intervention rate differed significantly (68.4% for rifampicin vs 48.8% for SSRIs; p=0.045) but the physician acceptance rate did not (84.6% for rifampicin vs 81.6% for SSRIs; p=1). Pharmaceutical interventions for SSRIs were more frequent when the ratio of the area under the drug concentration versus time curve in DDI-Predictor was >2. Pharmacists were more likely to issue a pharmacist intervention for DDIs involving rifampicin because of a high perceived risk of treatment failure and were less likely to issue a pharmacist intervention for DDIs involving an SSRI, except when the suspected interaction was strong.
CONCLUSIONS: DDI checkers can help pharmacists to manage DDIs involving strong interactors. DDIs involving strong inhibitors versus a strong inducer differ with regard to their intervention and acceptance rates, notably due to the estimation of the magnitude of the DDI.
METHODS: The pharmacist intervention rate and the physician acceptance rate were calculated for DDIs involving rifampicin or the SSRIs fluoxetine, paroxetine, duloxetine and sertraline. The rates were compared with a bilateral χ2 test or Fisher\'s exact test.
RESULTS: Of the 284 DDIs recorded, 38 (13.4%) involved rifampicin and 78 (27.5%) involved SSRIs. The pharmacist intervention rate differed significantly (68.4% for rifampicin vs 48.8% for SSRIs; p=0.045) but the physician acceptance rate did not (84.6% for rifampicin vs 81.6% for SSRIs; p=1). Pharmaceutical interventions for SSRIs were more frequent when the ratio of the area under the drug concentration versus time curve in DDI-Predictor was >2. Pharmacists were more likely to issue a pharmacist intervention for DDIs involving rifampicin because of a high perceived risk of treatment failure and were less likely to issue a pharmacist intervention for DDIs involving an SSRI, except when the suspected interaction was strong.
CONCLUSIONS: DDI checkers can help pharmacists to manage DDIs involving strong interactors. DDIs involving strong inhibitors versus a strong inducer differ with regard to their intervention and acceptance rates, notably due to the estimation of the magnitude of the DDI.
摘要：
目的：已经开发了几种药物-药物相互作用（DDI）检查程序，例如DDI-Predictor，用于检测和分级DDI。DDI-Predictor基于曲线下面积的比率来估计相互作用的大小。本研究的目的是分析涉及众所周知的强相互作用剂如利福平和选择性5-羟色胺再摄取抑制剂（SSRIs）的DDI的频率，根据使用DDI-Predictor的临床药学团队的报告，和药师干预的接受率。
方法：计算涉及利福平或SSRIs氟西汀的DDI的药师干预率和医师接受率，帕罗西汀,度洛西汀和舍曲林.采用双侧χ2检验或Fisher精确检验比较。
结果：在记录的284个DDI中，38例（13.4%）涉及利福平，78例（27.5%）涉及SSRIs。药剂师干预率显着差异（利福平为68.4％，SSRI为48.8％；p=0.045），但医师接受率却没有差异（利福平为84.6％，SSRI为81.6％；p=1）。当DDI-Predictor中药物浓度与时间曲线下面积的比值>2时，SSRIs的药物干预更为频繁。药剂师更有可能发布涉及利福平的DDI的药剂师干预，因为治疗失败的风险很高，并且不太可能发布涉及SSRI的DDI的药剂师干预。除非怀疑的互动很强烈。
结论：DDI检查可以帮助药剂师管理涉及强相互作用者的DDI。涉及强抑制剂的DDI与强诱导剂的DDI在干预和接受率方面有所不同。特别是由于对DDI大小的估计。
方法：计算涉及利福平或SSRIs氟西汀的DDI的药师干预率和医师接受率，帕罗西汀,度洛西汀和舍曲林.采用双侧χ2检验或Fisher精确检验比较。
结果：在记录的284个DDI中，38例（13.4%）涉及利福平，78例（27.5%）涉及SSRIs。药剂师干预率显着差异（利福平为68.4％，SSRI为48.8％；p=0.045），但医师接受率却没有差异（利福平为84.6％，SSRI为81.6％；p=1）。当DDI-Predictor中药物浓度与时间曲线下面积的比值>2时，SSRIs的药物干预更为频繁。药剂师更有可能发布涉及利福平的DDI的药剂师干预，因为治疗失败的风险很高，并且不太可能发布涉及SSRI的DDI的药剂师干预。除非怀疑的互动很强烈。
结论：DDI检查可以帮助药剂师管理涉及强相互作用者的DDI。涉及强抑制剂的DDI与强诱导剂的DDI在干预和接受率方面有所不同。特别是由于对DDI大小的估计。
