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. 2022 Jun;62(6):706-720.
doi: 10.1002/jcph.2020. Epub 2022 Feb 21.

Heterogeneity in the Identification of Potential Drug-Drug Interactions in the Intensive Care Unit: A Systematic Review, Critical Appraisal, and Reporting Recommendations

Tinka Bakker  1 , Dave A Dongelmans  2 , Ehsan Nabovati  3 , Saeid Eslami  1   4 , Nicolette F de Keizer  1 , Ameen Abu-Hanna  1 , Joanna E Klopotowska  1
Affiliations

Heterogeneity in the Identification of Potential Drug-Drug Interactions in the Intensive Care Unit: A Systematic Review, Critical Appraisal, and Reporting Recommendations

Tinka Bakker et al. J Clin Pharmacol. 2022 Jun.

Abstract

Patients admitted to the intensive care unit (ICU) are frequently exposed to potential drug-drug interactions (pDDIs). However, reported frequencies of pDDIs in the ICU vary widely between studies. This can be partly explained by significant variation in their methodological approach. Insight into methodological choices affecting pDDI frequency would allow for improved comparison and synthesis of reported pDDI frequencies. This study aimed to evaluate the association between methodological choices and pDDI frequency and formulate reporting recommendations for pDDI frequency studies in the ICU. The MEDLINE database was searched to identify papers reporting pDDI frequency in ICU patients. For each paper, the pDDI frequency and methodological choices such as pDDI definition and pDDI knowledge base were extracted, and the risk of bias was assessed. Each paper was categorized as reporting a low, medium, or high pDDI frequency. We sought associations between methodological choices and pDDI frequency group. Based on this comparison, reporting recommendations were formulated. Analysis of methodological choices showed significant heterogeneity between studies, and 65% of the studies had a medium to high risk of bias. High risk of bias, small sample size, and use of drug prescriptions instead of administrations were related to a higher pDDI frequency. The findings of this review may support researchers in designing a reliable methodology assessing pDDI frequency in ICU patients. The reporting recommendations may contribute to standardization, comparison, and synthesis of pDDI frequency studies, ultimately improving knowledge about pDDIs in and outside the ICU setting.

Keywords: drug-drug interaction identification; drug-drug interactions; intensive care; medication safety; patient safety; pharmacoepidemiology.

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Conflict of interest statement

All authors declare that they have no competing interests and that they have no financial disclosures.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses flow diagram. ICU, intensive care unit; pDDI, potential drug‐drug interaction.
See this image and copyright information in PMC

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