Assessment of Clinically Evident Drug Interactions among Inpatients: A Comprehensive Systematic Review

Main Article Content

Ahmad Khalaf Ramadan Alanazi, Khaled Obaid Hammad Albathali, Fahad Mohammed, Eid Almutairi, Murid Hamad Alanazi, Ismail Khalaf Mohammad Alshammari

Keywords

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Abstract

This study aimed to investigate the prevalence of clinically apparent drug-drug interactions (DDIs) among hospitalized patients.


Methods: A comprehensive search of PubMed, Scopus, Embase, Web of Science, and Lilacs databases was conducted to identify articles meeting predefined inclusion criteria . The search strategy utilized controlled and uncontrolled vocabulary related to "drug interactions," "clinically relevant," and "hospital." Included were original observational studies reporting DDIs in hospitalized patients, providing data for calculating prevalence, and describing drug prescriptions or DDI adverse reaction reports in English, Portuguese, or Spanish.


Results: Among 5,999 initial articles, 10 met the inclusion criteria. The pooled prevalence of clinically apparent DDIs was 9.2% (95% CI 4.0–19.7). Studies reported a mean of 4.0 to 9.0 medications per patient, averaging 5.47 ± 1.77 drugs. Moderate-quality studies predominantly identified DDIs through medical records and ward visits (n = 7). Micromedex® (27.7%) and Lexi-Comp® (27.7%) were commonly used databases for DDI detection, with no studies utilizing multiple databases.


Conclusions: This systematic review highlights that despite reported potential DDI prevalence, fewer than one in ten patients experienced clinically apparent drug interactions. Utilizing causality tools and implementing real DDI notification systems based on actual adverse outcomes are recommended strategies to mitigate alert fatigue, enhance decision-making for DDI prevention or resolution, and ultimately improve patient safety

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