Identification of drug interactions in clinical practice

The AIDS Drug Assistance Programme (ADAP) has been created to help states specifically provide prescription drug access to HIV-infected people ineligible for Medicaid and Medicare. The objective of this study was to assure the uninterrupted access to safe combinations of antiretroviral medications while attempting to determine the prevalence and prospectively restrict any contraindicated antiretroviral drug combination in New York State ADAP. Potential drug interactions were identified from the programme records dispensed over a 2-year period using Micromedex, www.hiv-druginteractions.org, and treatment guidelines.

Targeted dissemination of antiretroviral drug-drug interaction safety concerns to prescribers curtailed such practice by 87% (from 88 to 20 occurrences) with subsequent contraindicated drug-drug interactions denied at pharmacy. However, despite time and education, claims for contraindicated drug interactions still continue. Hard edits and clinical education are essential.

Rivera C, et al. The introduction of ART drug-drug interventions into the New York State AIDS Drug Assistance Program: the interaction of clinical pharmacology and standard of care. 16th CROI, Montreal, 2009. Abstract 701.
http://www.retroconference.org/2009/Abstracts/34581.htm