Back issues No.3 - 2011 / Original Study  

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Potential drug interactions in dermatologic outpatient prescriptions—experience from nationwide population-based study in Taiwan
Ying-Jui Chang , Min-Li Yeh , Yu-Chuan Li , Chien-Yeh Hsu , Yung-Tai Yen , Po-Yen Wang , Thomas Waitao Chu

Adverse drug reactions increase morbidity and mortality, and potential drug interactions (DIs) increase the probability of adverse drug reactions.

To survey the potential DIs of dermatologic outpatient prescriptions from the National Health Insurance Research Database of Taiwan.

All prescriptions written by dermatologists in 2000 were analyzed to identify potential DIs among drugs appearing on the same prescription sheet.

Of 150.6 million prescription sheets with 669.5 million prescriptions registered in the National Health Insurance Research Database of Taiwan, we identified 6.6 million (4.4%) dermatology prescription sheets with 19 million (2.8%) prescriptions. The findings of the study showed that 283,458 potential DIs were found in this category, accounting for 1.49% per prescription. The most common significance Level 1 interaction (1.1%) was between the less-sedative antihistamines (terfenadine/astemizole) and azole antifungal agents. Among the category of severity, the most common was terfenadine interacting with cimetidine and ketoconazole (4.4%), followed by astemizole interacting with cimetidine and ketoconazole (2.9%). The most common drug class interaction occurred between corticosteroids and antacids (48.5%). Overall, DI incidence in dermatologic patients was lower than that of the general patient population.

Based on the study findings, we concluded that dermatologists need to be reminded of having possible potential DIs when prescribing medications. Introducing information technology into the computerized physician order entry system into the daily practice may reduce potential DIs.

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