Specialists are less likely than generalists to spot clinically important drug-drug interactions
Research Activities, August 2009, No. 348
The pairing of incompatible prescription drugs can cause patients to suffer adverse events leading to emergency department visits or hospital stays. Physicians, as prescribers, are the first line of defense to prevent these potential drug-drug interactions (DDIs). However, of the 316 prescribers who answered survey questions on their information sources for DDIs, 68 percent said pharmacists often alerted them to a potential DDI. Another 16 percent said they relied on personal data assistants for DDI alerts, a new study reports.
Researchers found that generalists such as family practice, internal medicine, and emergency medicine physicians had higher knowledge scores of DDIs than specialists such as psychiatrists, neurologists, surgeons, and obstetricians/gynecologists. The former group may be more familiar with DDIs because they see a range of patients and have more occasions to prescribe a variety of drugs. Specialists, on the other hand, may deal with fewer drugs and thus may not be as familiar with DDIs, the authors state. Prescribers who had seen a patient harmed by a potential DDI had higher knowledge scores of DDIs. These prescribers may have spent more time thinking about potential DDIs and educating themselves on this issue. The authors suggest that clinicians, especially specialists, participate in education programs that present case studies. This approach could boost their awareness of DDIs and encourage them to pay close attention to potential DDIs when prescribing medication.
The authors caution that low response rates, ranging from 6.5 to 18.5 percent, to the 11,000 surveys mailed in 2005 mean that this study's results should not be generalized. They suggest that those who answered the survey could have had high levels of confidence in their ability to answer questions on DDIs correctly. This study was funded in part by the Agency for Healthcare Research and Quality (HS10385).
See "Potential determinants of prescribers' drug-drug interaction knowledge," by Yu Ko, Ph.D., Daniel C. Malone, Ph.D., Jerome B. D'Agostino, Ph.D., and others in the December 2008 Research in Social and Administrative Pharmacy 4(4), pp. 355-366.