Skip to main content

Advertisement

SpringerLink
Log in

SFINX—a drug-drug interaction database designed for clinical decision support systems

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

The aim was to develop a drug-drug interaction database (SFINX) to be integrated into decision support systems or to be used in website solutions for clinical evaluation of interactions.

Methods

Key elements such as substance properties and names, drug formulations, text structures and references were defined before development of the database. Standard operating procedures for literature searches, text writing rules and a classification system for clinical relevance and documentation level were determined. ATC codes, CAS numbers and country-specific codes for substances were identified and quality assured to ensure safe integration of SFINX into other data systems. Much effort was put into giving short and practical advice regarding clinically relevant drug-drug interactions.

Results

SFINX includes over 8,000 interaction pairs and is integrated into Swedish and Finnish computerised decision support systems. Over 31,000 physicians and pharmacists are receiving interaction alerts through SFINX. User feedback is collected for continuous improvement of the content.

Conclusion

SFINX is a potentially valuable tool delivering instant information on drug interactions during prescribing and dispensing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lazarou J, Pomeranz BH, Corey PN (1998) Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 279(15):1200–1205

    Article  PubMed  CAS  Google Scholar 

  2. Juurlink DN, Mamdani M, Kopp A, Laupacis A, Redelmeier DA (2003) Drug-drug interactions among elderly patients hospitalized for drug toxicity. JAMA 289(13):1652–1658

    Article  PubMed  CAS  Google Scholar 

  3. Bjerrum L, Andersen M, Petersen G, Kragstrup J (2003) Exposure to potential drug interactions in primary health care. Scand J Prim Health Care 21(3):153–158

    Article  PubMed  Google Scholar 

  4. Neuvonen PJ, Niemi M, Backman JT (2006) Drug interactions with lipid-lowering drugs: mechanisms and clinical relevance. Clin Pharmacol Ther 80(6):565–581

    Article  PubMed  CAS  Google Scholar 

  5. Pai MP, Graci DM, Amsden GW (2000) Macrolide drug interactions: an update. Ann Pharmacother 34(4):495–513

    Article  PubMed  CAS  Google Scholar 

  6. Mitchell PB (1997) Drug interactions of clinical significance with selective serotonin reuptake inhibitors. Drug Saf 17(6):390–406

    Article  PubMed  CAS  Google Scholar 

  7. Shear N, Drake L, Gupta AK, Lambert J, Yaniv R (2000) The implications and management of drug interactions with itraconazole, fluconazole and terbinafine. Dermatology 201(3):196–203

    Article  PubMed  CAS  Google Scholar 

  8. Hesse LM von Moltke LL, Greenblatt DJ (2003) Clinically important drug interactions with zopiclone, zolpidem and zaleplon. CNS Drugs 17(7):513–532

    Article  Google Scholar 

  9. US Food and Drug Administration (2006) Guidance for industry: drug interaction studies: study design, data analysis, and implications for dosing and labeling. http://www.fda.gov/cder/guidance/6695dft.pdf. Accessed 2008-10-09

  10. US Food and Drug Administration (1999) Guidance for industry: in vivo metabolism/drug interactions: study design, data analysis and recommendation for dosing and labeling. http://www.fda.gov/Cder/guidance/2635fnl.pdf. Accessed 2008-10-09

  11. EMEA: CPMP/ICH/291/95 (1998) Note for guidance on general considerations for clinical trials. http://www.emea.europa.eu/pdfs/human/ich/029195en.pdf. Accessed 2008-10-09

  12. Sindrup SH, Brosen K, Bjerring P, Arendt-Nielsen L, Larsen U, Angelo HR et al (1990) Codeine increases pain thresholds to copper vapor laser stimuli in extensive but not poor metabolizers of sparteine. Clin Pharmacol Ther 48(6):686–693

    PubMed  CAS  Google Scholar 

  13. Sindrup SH, Arendt-Nielsen L, Brosen K, Bjerring P, Angelo HR, Eriksen B et al (1992) The effect of quinidine on the analgesic effect of codeine. Eur J Clin Pharmacol 42(6):587–591

    Article  PubMed  CAS  Google Scholar 

  14. Tirkkonen T, Laine K (2004) Drug interactions with potential to preventing prodrug activation as a common source of irrational prescribing in hospital inpatients. Clin Pharmacol Ther 76(6):639–647

    Article  PubMed  CAS  Google Scholar 

  15. Garg AX, Adhikari NK, McDonald H, Rosas-Arellano MP, Deveraux PJ, Beyene J et al (2005) Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 293(10):1223–1238

    Article  PubMed  CAS  Google Scholar 

  16. van der Sijs H, Aarts J, Vulto A, Berg M (2006) Overriding of drug alerts in computerized physician order entry. J AM Med Inform Assoc 13(2):138–147

    Article  PubMed  Google Scholar 

  17. Bergk V, Haefeli WE, Gasse C, Brenner H, Martin-Facklam M (2005) Information deficits in the summary of product characteristics preclude an optmial management of drug interactions: a comparison with evidence from the literature. Eur J Clin Pharmacol 61(5-6):327–335

    Article  PubMed  Google Scholar 

  18. Wolters Kluwer (2008) Hansten and Horn’s drug interactions analysis and management. http://www.factsandcomparisons.com. Accessed 2008-10-09

  19. Pharmaceutical Press (2008) Stockley’s drug interactions online version. http://www.medicinescomplete.com. Accessed 2008-10-09

  20. Wolter Kluwers (2008) Drugline. http://www.ovid.com/site/catalog/Database/2816.jsp. Accessed 2008-10-09

  21. Thomson (2008) DRUGDEX, system provided by MICROMEDEX. http://www.thomsonhc.com/hcs/librarian/PFPUI/i2UCSoAjEX3J. Accessed 2008-10-09

  22. NCBI (2008) Medline. http://www.ncbi.nlm.nih.gov/sites/entrez. Accessed 2008-10-09

  23. Elsevier (2007) Embase. http://www.embase.com. Accessed 2008-10-09

  24. LIF (2008) Swedish PDR and SPC. http://www.fass.se. Accessed 2008-10-09

  25. Terveys (2008) Pharmaca fennica. http://www.terveysportti.fi. Accessed 2008-10-09

  26. EMEA (2008) The European public assessment reports (EPARs). http://www.emea.europa.eu/index/indexh1.htm. Accessed 2008-10-09

  27. Sjöqvist F (1997) A new classification system for drug interactions. Eur J Clin Pharmacol 52 (Suppl):327a

    Google Scholar 

  28. Liaw ST, Schattner P (2003) Electronic decision support in general practice. What’s the hold up? Aust Fam Physician 3211:941–944

    Google Scholar 

  29. Sjöborg B, Bäckström T, Arvidsson LB, Andersen-Karlsson E, Blomberg LB, Eiermann B et al (2007) Design and implementation of a point-of-care computerized system for drug therapy in Stockholm metropolitan health region-bridging the gap between knowledge and practice. Int J Med Info 76(7):497–506

    Article  Google Scholar 

  30. Eliasson M, Bastholm P, Forsberg P, Henriksson K, Jacobson L et al (2006) Janus computerised prescribing system provides pharmacological knowledge at point of care – design, development and proof of concept. Eur J Clin Pharmacol 62(4):251–258

    Article  PubMed  Google Scholar 

  31. Ahearn M, Kerr SJ (2003) General practitioners’ perceptions of the pharmaceutical decision-support tools in their prescribing software. Med J Aust 179(1):34–37

    PubMed  Google Scholar 

  32. Heikkilä T, Lekander T, Raunio H (2006) Use of an online surveillance system for screening drug interactions in prescriptions in community pharmacies. Eur J Clin Pharmacol 62(8):661–665

    Article  PubMed  Google Scholar 

  33. Grönroos PE, Irjala KM, Huupponen RK, Scheinin H, Forsstrom J, Forsström JJ (1997) A medication database – a tool for detecting drug interactions in hospital. Eur J Clin Pharmacol 53(1):13–17

    Article  PubMed  Google Scholar 

  34. Grizzle AJ, Mahmood MH, Ko Y, Murphy JE, Armstrong EP, Skrepnek GH (2007) Reasons provided by prescribers when overriding drug-drug interaction alerts. Am J Manag Care 13(10):573–578

    PubMed  Google Scholar 

  35. Thompson D, Oster G (1996) Use of terfenadine and contraindicated drugs. JAMA 275(17):1339–1341

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The Finnish Ministry of Health and Social Affairs, the Stockholm County Council and Karolinska Institutet, Stockholm, Sweden, for financial support.

Author information

Authors and Affiliations

  1. Department of Drug Management and Informatics, Stockholm County Council, Box 17533, SE-11891, Stockholm, Sweden

    Björn Molin, Lars L. Gustafsson & Birgit Eiermann

  2. medbase Ltd., Turku, Finland

    Kari Laine, Tuomas Korhonen & Tuire Tirkkonen

  3. Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Turku, Finland

    Kari Laine, Tuomas Korhonen & Tuire Tirkkonen

  4. Unit of Clinical Pharmacology, TYKSLAB, Turku, Finland

    Kari Laine, Tuomas Korhonen & Tuire Tirkkonen

  5. Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, SE-141 86, Stockholm, Sweden

    Ylva Böttiger, Marine L. Andersson, Marie-Louise Ovesjö, Anders Rane & Lars L. Gustafsson

Authors
  1. Ylva Böttiger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kari Laine
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marine L. Andersson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tuomas Korhonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Björn Molin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marie-Louise Ovesjö
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tuire Tirkkonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anders Rane
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lars L. Gustafsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Birgit Eiermann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Birgit Eiermann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Böttiger, Y., Laine, K., Andersson, M.L. et al. SFINX—a drug-drug interaction database designed for clinical decision support systems. Eur J Clin Pharmacol 65, 627–633 (2009). https://doi.org/10.1007/s00228-008-0612-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-008-0612-5

Keywords

Search

Navigation