How do different drug interaction databases compare in detecting and classifying drug-drug interactions associated with dual antihypertensive therapy?
There is considerable variability and poor agreement among major drug interaction databases regarding dual antihypertensive therapy, highlighting the need to use multiple databases in clinical practice.
Drug-drug interactions (DDIs) associated with dual antihypertensive therapy may compromise therapeutic outcomes and increase the risk of adverse drug reactions (ADRs). The accuracy and consistency of databases in detecting DDIs play a crucial role in ensuring medication safety. However, variations in the scope, completeness, severity and consistency of information across different databases necessitate a comparative evaluation. This study aims to perform a comparative evaluation of databases in detecting and classifying DDIs associated with dual antihypertensive therapy. A set of clinically significant antihypertensive drug pairs was selected based on their clinical relevance and potential for DDIs. Eight databases namely UpToDate, Lexicomp, Medscape, Epocrates, Drugs.com, WebMD, DrugBank, and RxList were utilized to assess the selected drug pairs for the evaluation of DDIs. Each database was evaluated for scope and completeness. The intersource reliability of the studied databases was evaluated using Cohen's kappa score. A total of 75 antihypertensive drug pairs were selected for the present study. The highest scope score (100%) was observed in UpToDate, Lexicomp, and DrugBank. Lexicomp demonstrated the highest completeness score (90.41%). Most databases reported a higher proportion of moderate interactions. The highest percentage of major interactions was reported by Drugs.com (43.3%), while DrugBank recorded a notable percentage of minor interactions (26.6%). The Cohen's kappa (k) values indicated statistically significant (p < 0.001) but poor agreement (k < 0.2) among the databases. The comparative evaluation of databases revealed considerable variability in the scope, completeness, and consistency of drug-drug interaction information associated with dual antihypertensive therapy. The observed low intersource reliability highlights the need for standardization and harmonization across databases to ensure consistent and accurate drug interaction information. These findings underscore the importance of utilizing multiple databases in clinical practice to enhance medication safety and optimize patient care.
Alam et al. (Thu,) studied this question.