Implementation and outcome of herb-drug interaction alert system at one teaching hospital in Taiwan

• Main Authors: Er-Ying Wang, 王爾瑩
• Other Authors: 簡淑真
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/75738725885906173470

碩士 === 臺北醫學大學 === 藥學研究所 === 98 === Background: The widely use of herbal products among the public has raised some concerns regarding issues of herb-drug interactions. In Taiwan, traditional medicine (TM) continues to be widely used. However, current information about herb-drug interactions, including the incidence of herb-drug interactions and the risk of related adverse drug events (ADEs) in Taiwan are still limited. Objectives: The purpose of this study is to (1) establish a herb-drug interaction alert system; (2) estimate the incidence of herb-drug interactions and the risk of ADEs related to herb-drug interaction; (3) evaluate the outcomes of implementation of the herb-drug interaction alert system. Method: (1) The potential herb-drug interactions in the alert system were established based on case reports, clinical trials, or theoretical interactions. (2) Outpatients who had also visited traditional medicine clinics and had potential herb-drug interaction(s) in 2009 and 3 months after implementation of alert system were enrolled. Patient’s demographic information, the information on the prescriptions and laboratory data were collected from health information system to evaluate the incidence and the patterns of herb-drug interactions, and the risk of ADEs. (3) Information from alert system was collected to evaluate the doctors’ reply after receiving the alerts. Results: There were 1,891 potential herb-drug interactions documented in the herb-drug interaction alert system, 61 (3.2%) interactions were based on case reports. In 2009, the incidence of herb-drug interactions was 13.7%. There were 563 patients had potential herb-drug interactions, 72.3% were female, the most common western medicines were antihypertensive agents (25.5%), hypoglycemics (22.3%), antacids (17.4%) and anticoagulants (17.3%). Among these patients, 4 (0.7%) patients experienced an adverse drug event related to herb-drug interaction(s). The incidence of herb-drug interactions after implementation of alert system was decreased from 15.1% to 11.2% (p = 0.014), and approximately 36.2% of doctors changed prescription medicine after receiving the alarm information and and 27.7% monitored available parameters. Conclusion: The incidence of herb-drug interactions among outpatients was 13.7%, and the risk of ADEs was 0.7%. The incidence of herb-drug interactions significantly decreased to 11.2% (p = 0.014) after implementation of the herb-drug interaction alert system. The information of evidence-based herb-drug interactions is still limited, more studies are needed in the future.