@article {LaptosA20, author = {T Laptos and P Volk Markovic and A Cufar}, title = {CP-051 Evaluation of electronic drug interaction checker databases {\textendash} rheumatoid arthritis patients case study}, volume = {22}, number = {Suppl 1}, pages = {A20--A21}, year = {2015}, doi = {10.1136/ejhpharm-2015-000639.49}, publisher = {BMJ Specialist Journals}, abstract = {Background Due to sometimes difficult pharmacological management of the disease and comorbidities, patients with rheumatoid arthritis (RA) are often subjected to multi-drug treatment. Electronic databases with drug interaction checker functions can be a useful tool to predict potential drug-drug interactions; however the descriptions may not always be supported by adequate data.Purpose To evaluate the validity and appropriateness of drug-drug interaction descriptions of a commercial and an open-access database.Material and methods The medical records of 25 patients receiving 5 or more medicines (N = 8,64 {\textpm} 1,95) were analysed. The majority (84\%) were receiving methotrexate and 16\% were on additional biological treatment (adalimumab, etanercept or tocilizumab).Lexi-comp and Drugs.com databases were used to identify potential interactions. The descriptions rated D (N = 26) or X (N = 1) (Lexi-comp) or Major (N = 21) (Drugs.com) were reviewed. The interaction descriptions were classified as either (1) appropriate (data based on primary sources and/or medicinal products{\textquoteright} SmPCs), (2) undefined (general descriptions including multiple drugs or inconclusive data) or (3) inappropriate (data not corroborated by primary sources or misinterpreted).Results The Lexi-comp and Drugs.com descriptions of interaction were deemed {\textquotedblleft}appropriate{\textquotedblright} (63 vs. 48\%), {\textquotedblleft}undefined{\textquotedblright} (26 vs. 33\%) and {\textquotedblleft}inappropriate{\textquotedblright} (11 vs. 19\%) respectively. The majority of {\textquotedblleft}undefined{\textquotedblright} classifications were describing class effects. The overestimation of biologicals and methotrexate interactions (even though concomitant use is recommended by current guidelines) was the main cause for {\textquotedblleft}inappropriate{\textquotedblright} classifications.Conclusion The databases with interaction checker functions provide a powerful tool for a pharmacist when reviewing the patient{\textquoteright}s treatment. Nevertheless, in patients with RA, due to simultaneous use of a variety of immunomodulatory drugs, the databases tend to overestimate the class effect of those medicines. Our data shows that only about one half (56\% overall) of potential interactions described in them can be classified as {\textquotedblleft}appropriate{\textquotedblright}. It is therefore crucial that the pharmacist{\textquoteright}s final decision is based on clinical data.References and/or Acknowledgements Professional advice of R. Antolic, MSc is highly appreciatedNo conflict of interest.}, issn = {2047-9956}, URL = {https://ejhp.bmj.com/content/22/Suppl_1/A20.3}, eprint = {https://ejhp.bmj.com/content/22/Suppl_1/A20.3.full.pdf}, journal = {European Journal of Hospital Pharmacy} }