Potential drug interactions in adults living in Manaus: a real-world comparison of two databases, 2019

INTRODUCTION: Software systems are commonly used by professionals to assist identification of drug interactions and to ensure the safe use of medications. Real-world evidence about the comparison of different drug interaction sources is scarce. Objective: To compare two drug interaction databases used to identify interactions in a population-based survey.
METHODS: This is a cross-sectional study based on a previous survey performed in the city of Manaus, Brazil, in 2019. We included adults aged 18 years and over who used two or more medicines 15 days prior to the interview. In order to assess potential drug interactions, we searched Micromedex and UpToDate databases. The primary outcome was the prevalence of potential drug interactions in each database. Weighted Kappa statistics was calculated to assess agreement on the presence of drug interaction, documentation and severity.
RESULTS: A total of 752 participants were included in the study. The prevalence of drug interactions was 43.8% (95% CI: 40.2, 47.3%) in UpToDate and 30.2% (95% CI: 26.9, 33.5%) in Micromedex. The agreement related to drug interactions between the two databases was fair (Kappa=0.631). For r severity (Kappa=0.398) and documentation (Kappa=0.311), the agreement was poor.
DISCUSSION AND CONCLUSION: Agreement among compared databases was sub-optimal. Better quality and transparency on evidence available in drug interaction sources are needed to support informed health care professionals’ decision.