TY - JOUR
T1 - Heterogeneity in the Identification of Potential Drug-Drug Interactions in the Intensive Care Unit
T2 - A Systematic Review, Critical Appraisal, and Reporting Recommendations
AU - Bakker, Tinka
AU - Dongelmans, D
AU - Nabovati, Ehsan
AU - Eslami Hassanabadi, Saeid
AU - de Keizer, Nicolette F.
AU - Abu-Hanna, Ameen
AU - Klopotowska, Joanna E.
N1 - Funding Information: This study was funded by The Netherlands Organization for Health Research and Development (ZonMw projectnumber: 80‐83600‐98‐40140). The funder had no role in the design of the study or writing the manuscript. Publisher Copyright: © 2021 The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.
PY - 2022/6
Y1 - 2022/6
N2 - Patients admitted to the intensive care unit (ICU) are frequently exposed to potential drug-drug interactions (pDDIs). However, reported frequencies of pDDIs in the ICU vary widely between studies. This can be partly explained by significant variation in their methodological approach. Insight into methodological choices affecting pDDI frequency would allow for improved comparison and synthesis of reported pDDI frequencies. This study aimed to evaluate the association between methodological choices and pDDI frequency and formulate reporting recommendations for pDDI frequency studies in the ICU. The MEDLINE database was searched to identify papers reporting pDDI frequency in ICU patients. For each paper, the pDDI frequency and methodological choices such as pDDI definition and pDDI knowledge base were extracted, and the risk of bias was assessed. Each paper was categorized as reporting a low, medium, or high pDDI frequency. We sought associations between methodological choices and pDDI frequency group. Based on this comparison, reporting recommendations were formulated. Analysis of methodological choices showed significant heterogeneity between studies, and 65% of the studies had a medium to high risk of bias. High risk of bias, small sample size, and use of drug prescriptions instead of administrations were related to a higher pDDI frequency. The findings of this review may support researchers in designing a reliable methodology assessing pDDI frequency in ICU patients. The reporting recommendations may contribute to standardization, comparison, and synthesis of pDDI frequency studies, ultimately improving knowledge about pDDIs in and outside the ICU setting.
AB - Patients admitted to the intensive care unit (ICU) are frequently exposed to potential drug-drug interactions (pDDIs). However, reported frequencies of pDDIs in the ICU vary widely between studies. This can be partly explained by significant variation in their methodological approach. Insight into methodological choices affecting pDDI frequency would allow for improved comparison and synthesis of reported pDDI frequencies. This study aimed to evaluate the association between methodological choices and pDDI frequency and formulate reporting recommendations for pDDI frequency studies in the ICU. The MEDLINE database was searched to identify papers reporting pDDI frequency in ICU patients. For each paper, the pDDI frequency and methodological choices such as pDDI definition and pDDI knowledge base were extracted, and the risk of bias was assessed. Each paper was categorized as reporting a low, medium, or high pDDI frequency. We sought associations between methodological choices and pDDI frequency group. Based on this comparison, reporting recommendations were formulated. Analysis of methodological choices showed significant heterogeneity between studies, and 65% of the studies had a medium to high risk of bias. High risk of bias, small sample size, and use of drug prescriptions instead of administrations were related to a higher pDDI frequency. The findings of this review may support researchers in designing a reliable methodology assessing pDDI frequency in ICU patients. The reporting recommendations may contribute to standardization, comparison, and synthesis of pDDI frequency studies, ultimately improving knowledge about pDDIs in and outside the ICU setting.
KW - drug-drug interaction identification
KW - drug-drug interactions
KW - intensive care
KW - medication safety
KW - patient safety
KW - pharmacoepidemiology
UR - http://www.scopus.com/inward/record.url?scp=85125109245&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/jcph.2020
DO - https://doi.org/10.1002/jcph.2020
M3 - Review article
C2 - 34957573
SN - 0091-2700
VL - 62
SP - 706
EP - 720
JO - Journal of clinical pharmacology
JF - Journal of clinical pharmacology
IS - 6
ER -