CLINICAL SIGNIFICANCE OF AVAILABLE DRUG INFORMATION RESOURCES REGARDING DRUG-DRUG INTERACTIONS: AN AUDIT FROM A TERTIARY CARE CANCER CENTRE IN INDIA
Author(s)
Shreya C. More, Pharm D1, Dr. Amit Joshi, Professor & HOD, Dept. of Medical Oncology, ACTREC2, Dr Tanuj Chawla, Consultant, Dept. of Clinical Pharmacology, ACTREC2;
1Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pharmacy practice, Pune, India, 2Tata Memorial Hospital, Medical Oncology, Navi Mumbai, India
1Dr. D.Y. Patil Dnyan Prasad University's School of Pharmacy and Research, Pharmacy practice, Pune, India, 2Tata Memorial Hospital, Medical Oncology, Navi Mumbai, India
OBJECTIVES: To determine the clinical relevance of five drug interaction (DI) resources regarding Drug-Drug interaction (DDI) and to develop methods to mitigate the differences in managing DDIs.
METHODS: A prescription audit was conducted between 15th Aug 2025 to 31st Oct 2025 using five Drug Information (DI) resources, i.e. Micromedex®, UpToDate®, DrugBank Interaction Checker (DBIC), Drugs.com Drug Interaction Checker (DDIC) and Medscape.com Drug Interaction Checker (MDIC). A Scope score was given by calculating the percentage of interactions captured by them. A higher Scope score reflects broader coverage of the DDIs. Each DI resource was also given a Completeness score describing severity, clinical information, mechanisms, and DDI management. The higher score indicated detailed and clinically useful information. We then derived our own recommendations based on the audit and literature search.
RESULTS: Data of 80 patients were captured, i.e. 30 chemotherapy and 50 were combined chemo-nonchemotherapy medicines. We identified 185 DDIs, in which 16 were Anticancer-Anticancer, 55 were Anticancer-Non Anticancer, and 114 were Non Anticancer-Non Anticancer drug combinations. DBIC had the highest Scope score of 57%, followed by UpToDate (46%), while MDIC showed the lowest score i.e. 31%. DBIC clocked the highest completeness score of 99.7%, closely followed by UpToDate (98%), while DDIC fared poorly at 86%.According to our literature search, 34% (63/185) of DDIs were not clinically significant. DDIs were categorised into major, moderate, or minor, as per their severity, as mentioned in the DI resources. Cumulatively, 25% (27/108), 39% (57/147) and 39% (9/23) of major, moderate and minor interactions were clinically not significant, respectively.
CONCLUSIONS: DI resources for DDIs are unreliable, especially in oncology settings. We formulated our own hospital-specific guide to manage the DDIs, and we recommend the same for everyone.
METHODS: A prescription audit was conducted between 15th Aug 2025 to 31st Oct 2025 using five Drug Information (DI) resources, i.e. Micromedex®, UpToDate®, DrugBank Interaction Checker (DBIC), Drugs.com Drug Interaction Checker (DDIC) and Medscape.com Drug Interaction Checker (MDIC). A Scope score was given by calculating the percentage of interactions captured by them. A higher Scope score reflects broader coverage of the DDIs. Each DI resource was also given a Completeness score describing severity, clinical information, mechanisms, and DDI management. The higher score indicated detailed and clinically useful information. We then derived our own recommendations based on the audit and literature search.
RESULTS: Data of 80 patients were captured, i.e. 30 chemotherapy and 50 were combined chemo-nonchemotherapy medicines. We identified 185 DDIs, in which 16 were Anticancer-Anticancer, 55 were Anticancer-Non Anticancer, and 114 were Non Anticancer-Non Anticancer drug combinations. DBIC had the highest Scope score of 57%, followed by UpToDate (46%), while MDIC showed the lowest score i.e. 31%. DBIC clocked the highest completeness score of 99.7%, closely followed by UpToDate (98%), while DDIC fared poorly at 86%.According to our literature search, 34% (63/185) of DDIs were not clinically significant. DDIs were categorised into major, moderate, or minor, as per their severity, as mentioned in the DI resources. Cumulatively, 25% (27/108), 39% (57/147) and 39% (9/23) of major, moderate and minor interactions were clinically not significant, respectively.
CONCLUSIONS: DI resources for DDIs are unreliable, especially in oncology settings. We formulated our own hospital-specific guide to manage the DDIs, and we recommend the same for everyone.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD39
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology