DRPs are estimated to be among the top 10 causes of mortality in the US, costing more than $1,000 per patient per year
Drug-related problems (DRPs) address many problem types such as; drug-drug interactions, drug-patient factor interactions, duplicate therapies, allergies, drug-food interactions, pharmacogenetics and dosing. They also have a huge impact on patients’ health and health economics 1-3. DRPs are among the top 10 causes of mortality in the US; more than car accidents, alcohol-induced fatalities and homicide4. More than 20% of those who receive >5 concomitant drugs may exhibit severe consequences related to DRPs 5-8, about 6-10% of hospital admissions are due directly to DRPs 9-11, while the costs attributed to DRPs are estimated to be >$1,000 per patient per year 1-3. Unfortunately, most data suggests that 90-95% of alerts are overridden by physicians 12-15.
1. Drug-related morbidity and mortality. Updating the cost-of-illness model. Ernst FR and Grizzle AJ. J Am Pharm Assoc 2001; 41:192-9.
2. The Costs of Adverse Drug Events in Hospitalized Patients. Bates et al. JAMA 1997; 277:307-11.
3. Provision of clinical pharmacy services in two safety net provider settings. Connor SE et al., Pharmacy Practice 2009;7:94-99.
4. 2013 Mortality Multiple Cause Micro-data Files. Tables 10, 12, 13. at: http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm.
5. Medication-related problems commonly occurring in an Australian community. Roughead EE et al., Pharmacoepidemiology and Drug Safety 2004 13:83-87.
6. Prevalence of drug-related problems and cost-savings opportunities in Medicaid high utilizers identified by a pharmacist-run drug regimen review center. LaFleur J et al., Journal of Managed Care Pharmacy 2006 12:677-685.
7. Prevalence and safety-relevance of drug-related problems in German community pharmacies. Lewinski D et al., Pharmacoepidemiology and Drug Safety 2010 19:141-149.
8. Problems related to medication in ambulatory care. Franco M et al., Farmaceuticos de Atencion Primaria 2012 10:3-8.
9. Prevalence of medication-related hospitalizations: A systematic review & meta-analysis. Souza TT et al., International Journal of Clinical Pharmacy 2013; 35: 1335.
10. Adverse drug reactions as a cause for admissions to a dept. of internal medicine. Mjörndal T et al., Pharmacoepidemiology and Drug Safety 2002; 11:65-72.
11. Drug-related Adverse Events. Janet Woodcock, M.D.; Director Center for Drug Evaluation and Research, Food and Drug Administration 2000; before the Senate Committee on Health, Education, Labor, and Pensions. www.cdc.gov/nchs/data_access.
12. Drug safety alert generation and overriding in a large Dutch university medical centre. Van Der Sijs H et al., Pharmacoepidemiology and Drug Safety 2009; 18:941-947.
13. Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. Bryant AD et al., Applied clinical informatics 2014 5:802-813.
14. Physicians’ responses to computerized drug–drug interaction alerts for outpatients. Min-Li Yeha b et al., Computer Methods and Programs in Biomedicine 2013; 111:17-25.
15. Drug-drug interactions that should be noninterruptive in order to reduce alert fatigue in electronic health records. Phansalkar S et al., Journal of the American Medical Informatics Association 2013; 20:489-493.