Informatics confronts drug-drug interactions

Abstract

Drug-drug interactions (DDIs) are an emerging threat to public health. Recent estimates indicate that DDIs cause nearly 74000 emergency room visits and 195000 hospitalizations each year in the USA. Current approaches to DDI discovery, which include Phase IV clinical trials and post-marketing surveillance, are insufficient for detecting many DDIs and do not alert the public to potentially dangerous DDIs before a drug enters the market. Recent work has applied state-of-the-art computational and statistical methods to the problem of DDIs. Here we review recent developments that encompass a range of informatics approaches in this domain, from the construction of databases for efficient searching of known DDIs to the prediction of novel DDIs based on data from electronic medical records, adverse event reports, scientific abstracts, and other sources. We also explore why DDIs are so difficult to detect and what the future holds for informatics-based approaches to DDI discovery.

Figure 1

(a) Number of prescription drugs used in the past 30 days by percentage of the USA population (age-adjusted estimates). Source: National Center for Health Statistics. Health, United States, 2011: With Special Feature on Socioeconomic Status and Health. Hyattsville, MD. 2012. Table 99: Prescription drug use in the past 30 days, by sex, age, race, and Hispanic origin: United States, selected years 1988–1994 through 2007–2010. (b) Average number of prescriptions filled in 2011 in the USA by age. The data include both new prescriptions and refills, brand name, and generic drugs. Source: The Kaiser Family Foundation, statehealthfacts.org, accessed September 14, 2012. Data source: SDI Health, LLC: Special Data Request, 2012. Calculations based on 2011 population estimates from the US Census Bureau.