Abstract

OBJECTIVE:

To evaluate the performance of computerized drug-drug interaction (DDI) software in identifying clinically important drug-drug interactions.

DESIGN:

One-time performance test of computer systems using a standard set of prescriptions.

SETTING:

Community pharmacies or central corporate locations with pharmacy terminals identical to those used in actual pharmacies.

PARTICIPANTS:

Chain and health maintenance organization (HMO) pharmacies with seven or more practice sites in Washington State. A total of nine different DDI software programs were installed in 516 community pharmacies represented by these chains and HMOs.

MAIN OUTCOME MEASURES:

Sensitivity, specificity, and positive and negative predictive values of software in detecting 16 well-established DDIs contained within six fictitious patient profiles.

RESULTS:

The software systems failed to detect clinically relevant DDIs one-third of the time. Sensitivity of the software programs ranged from 0.44 to 0.88, with 1.00 being perfect; specificity ranged from 0.71 to 1.00; positive predictive value ranged from 0.67 to 1.00; and negative predictive value ranged from 0.69 to 0.90. For software packages that were installed at different locations, between-installation differences were observed.

CONCLUSION:

The performance of most DDI-detecting software programs tested in this study was suboptimal. Improvement is needed to advance their contribution to detection of DDIs.