Interest Material
Drug Utilization Study of Potential Drug-drug Interactions using the Sampling Dataset of the National Database of Health Insurance Claim Information
2014 Volume 34 Issue 6 Pages 293-304
Details
2014 Volume 34 Issue 6 Pages 293-304
Development of community-wide medical collaboration has been enabling for community pharmacies to check patient’s prescriptions with medical records and pharmacy claims. To our knowledge, however, there have been little studies showing the need for such a collaboration with factual data. We therefore conducted a drug utilization study investigating the prevalence of potential drug-drug interactions using the national database of health insurance claim information, provided by the Ministry of Health, Labour and Welfare.
Of the number of 755,247 outpatient claims, 543,506 (72.0%) patients had their prescription filled at a community pharmacy. Of 431,873 patients with concomitant use of oral drugs, the number of those who were administered a drug combination with caution for concomitant use, a combination with extreme caution for concomitant use and a contraindicated combination according to product’s labels were 204,067 (47.3%), 946 (0.2%) and 275 (0.1%) respectively. The frequency of patients administered a drug combination with caution for concomitant use increased with age, and the most frequent agents involved in these combinations were cardiovascular agents, antidiabetics, and agents affecting central nervous system. Lipid-regulating drugs was the only drugs involved in extreme caution for concomitant use, and antimigraine drugs, drugs including metal irons, antifungals, macrolides, and immunosuppressants were the most frequent drugs involved in a contraindicated combination, along with cardiovascular agents and agents affecting central nervous system.
As to a contraindicated drug combination between medical claims and pharmacy claims, many drugs in these combinations were indicated for different diagnosis from the other drugs.
Considering that the majority of outpatients had their prescriptions filled in a community pharmacy, there is a real need for the development of a community-wide medical collaboration.
