Scope, Completeness, and Accuracy of Drug Information in Wikipedia
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Drug– drug interaction (DDI) is an
important issue among the cancer
population.
It is commonly observed in
these patients, especially because they
often receive multiple medications concurrently with complex chemotherapy
regimens.
It...
[More]
Drug– drug interaction (DDI) is an
important issue among the cancer
population.
It is commonly observed in
these patients, especially because they
often receive multiple medications concurrently with complex chemotherapy
regimens.
It was shown previously that
patients who are taking multiple medications for the treatment of comorbid illnesses experience an increased incidence
of drug interactions.
1,2
Other factors, such
as age-related renal and/or hepatic insufficiency, can also affect drug metabolism,
elimination, and clearance, causing elderly patients with cancer to become even
more susceptible to DDI effects.
3
Over the past few years, there has
been a paradigm shift in cancer treatment from parenteral to oral drug administration,4
with many of the newly approved anticancer agents being administered orally.
Oral anticancer treatment
offers patients greater convenience and
flexibility for timing and location of drug
administration, reduced use of healthcare
resources, and most importantly, a better
quality of life compared with parenteral anticancer therapy.
Despite these benefits, potential hazards of oral treatment include interactions with other prescription and nonprescription
medications as well as complementary therapies.
Several risk
factors predispose patients with cancer who are receiving oral
anticancer agents to develop adverse DDIs; these include
malabsorption, malnutrition, disease states, and pharmacokinetic differences in individual patients.
5
One way to prevent DDI mishaps is early recognition of
the interaction, particularly in patients who are receiving
concomitant oral anticancer and nonanticancer agents.
Regarding early recognition, clinicians can use drug compendia to research DDI information.
Currently, a number of
commercial DDI databases are available; compendia such
as Drug Information Facts (DIF) and Micromedex are
commonly used resources that can provide detailed DDI
information including onset, severity, scientific evidence,
pharmacologic effects, mechanisms of action, and management.
Although references can be helpful in identifying
The Annals of Pharmacotherapy I 2008 December, Volume 42 I 1737
Clinically Significant Drug–Drug Interactions Between Oral
Anticancer Agents and Nonanticancer Agents:
Profiling and Comparison of Two Drug Compendia
Chen-May Wong, Yu Ko, and Alexandre Chan
www.
theannals.
com
Oncology
Author information provided at the end of the text.
RESEARCH REPORTS
BACKGROUND: Use of oral anticancer agents is gaining wide acceptance in the
treatment of cancer.
However, patients receiving oral therapy are at high risk for
drug–drug interactions (DDIs).
OBJECTIVE: To create a drug profile for each clinically significant DDI involving
selected oral anticancer agents and evaluate the agreement between 2
commonly used DDI compendia: Drug Interaction Facts (DIF) 2008 and Micromedex DRUGDEX.
METHODS: DDI profiles were developed based on primary and tertiary literature
reviews.
DIF 2008 and Micromedex DRUGDEX were compared to assess the
consistency of listings, severity, and scientific evidence ratings of DDIs involving
the oral anticancer agents that were selected.
The Spearman correlation test was
used to assess the correlation of the severity ratings between the 2 compendia.
RESULTS: A total of 184 DDIs were identified.
A DDI profile was created for 40 of
these that met the predetermined criteria for clinically significant interactions.
The
comparative assessment showed inconsistency in DDI listings (15.
2% of those
identified were listed in DIF only and 46.
7% were listed in Micromedex only),
severity ratings (Spearman correlation coefficient 0.
49), and scientific evidence
ratings (disagreement 25.
8%).
CONCLUSIONS: The discrepancies in DDI listing and rating systems between the
compendia evaluated here reflect the need for more studies to standardize the
definitions and classifications of DDIs.
KEY WORDS: drug compendia, drug–drug interactions, drug information.
Ann Pharmacother 2008;42:1737-48.
Published Online, 25 Nov 2008, www.
theannals.
com, DOI 10.
1345/aph.
1L255
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