DDI alerts & sequence indications

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jerome
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DDI alerts & sequence indications

Post by jerome » 16 October 2014, 04:09

The problem:

An alert can be relevant when new drug A is added to an existing regimen containing drug B, but not if new drug B is added to existing drug A.

An example:

Starting an angiotensin-converting enzyme inhibitor in a patient using diuretics may cause severe hypotension and should be performed with low doses, whereas a patient chronically taking angiotensin-converting enzyme inhibitors can start with diuretics without such precautionary measures.

So FreeMedForms/FreeDiams should take "sequence" into account. We need to know which drug is new and which one is already prescribed to the patient. How do we do that?

Do we have start/stop dates in the prescription data? Maybe we should. And also have the possibility to set a start date in the past for new patients.

We also need to modify the structure of the DDI knowledge base so that it knows that for some drugs, A+B != B + A

We have to review the literature to know the duration of diuretics treatment after which it is considered potentially hazardous to start ACE inhibitors at full dose.

That's a job for the FreeMedForms Interaction Committee! :)

Reference:

Van der Sijs, H., J. Aarts, T. van Gelder, M. Berg, and A. Vulto. “Turning Off Frequently Overridden Drug Alerts: Limited Opportunities for Doing It Safely.” Journal of the American Medical Informatics Association 15, no. 4 (April 24, 2008): 439–48. doi:10.1197/jamia.M2311.

Full text pdf of this article is available on the Zotero Group page: https://www.zotero.org/groups/freemedfo ... y/Q5JX4JZE (look at the bottom of the page for Notes and Attachments)

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