Improving the quality and safety of drug interaction decision support offered by electronic clinical systems in general practice and community pharmacy in Australia
Doctors and pharmacists using prescribing or dispensing software receive warning messages when interacting drugs are prescribed for a patient. The software programs currently in use in Australia utilise a range of reference sources for this information, including MIMs, APP Guide, Micromedex or in-house databases. The warnings are displayed in different ways and offer varying types of information about severity and management.
The variability in electronic drug interaction decision support in software programs is undesirable. It is primarily due to the underlying reference source used, but also exists between systems using the same reference source. Similar variability has been noted overseas. In addition, users have commented that many of the warnings are unhelpful or annoying, resulting in a tendency to ignore warning messages.
The goal of this project is to provide useful information on clinically relevant drug interactions, which is consistent throughout Australia. The National Prescribing Service (NPS) is working with Australian Medicines Handbook (AMH) to develop high quality, educational electronic drug interaction data for use in all prescribing and dispensing software. The AMH drug interaction data is a result of a comprehensive review of relevant literature. NPS is investigating the feasibility of offering targeted interaction information via the Internet (as a Web service).
An expert panel has been assembled and a scoping study is underway. A sample list of interactions identified by the panel (both serious/clinically significant and theoretical/minor interactions) will be compared in various reference sources including the AMH, and in the commonly used prescribing and dispensing programs in Australia. The expert panel will report on the quality and relevance of the information presented in different reference sources and programs. These results will be used to inform the future direction of the project.