Critical issues associated with drug–drug interactions: Highlights of a multistakeholder conference

Although many potential drug–drug interactions (DDIs) are clinically inconsequential, DDI-associated harm does occur.1–6 The magnitude of harm caused by DDIs is not precisely known, but research suggests that DDIs may be a significant public health issue.2–6 Americans are frequently exposed to clinically important DDIs despite advances in health information technology designed to warn clinicians about potentially harmful drug combinations.7,8 System design issues and problems with the DDI evidence base are partly responsible for exposure to these potential hazards. The nation’s health care system is undergoing a transformation to improve the quality, safety, and efficiency of care. Under the Health Information Technology for Economic and Clinical Health Act of 2009, implementation of electronic DDI and drug–allergy checking is one of the core “meaningful-use” objectives that providers must meet to qualify for financial incentives when they adopt certified electronic health record technology.9 With the meaningful-use regulation and other initiatives promoting electronic prescribing (e-prescribing), there is an even greater need to improve the generation, evaluation, and integration of DDI evidence into clinical decision-support (CDS) systems to maximize the value of these technologies.