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Clinical usefulness of drug-laboratory test interaction alerts: a multicentre survey

  • Jasmijn A. van Balveren EMAIL logo , Wilhelmine P. H. G. Verboeket-van de Venne , Carine J. M. Doggen , Anne S. Cornelissen , Lale Erdem-Eraslan , Albert J. de Graaf , Johannes G. Krabbe , Ruben E. A. Musson , Wytze P. Oosterhuis , Yolanda B. de Rijke , Heleen van der Sijs , Andrei N. Tintu , Rolf J. Verheul , Rein M. J. Hoedemakers , Ron Kusters , Dutch Society for Clinical Chemistry and Laboratory Medicine and task group ‘SMILE’: Signaling Medication Interactions and Laboratory test Expert system
Published/Copyright: February 25, 2021
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 59 Issue 7

Abstract

Objectives

Knowledge of possible drug-laboratory test interactions (DLTIs) is important for the interpretation of laboratory test results. Failure to recognize these interactions may lead to misinterpretation, a delayed or erroneous diagnosis, or unnecessary extra diagnostic tests or therapy, which may harm patients. The aim of this multicentre survey was to evaluate the clinical value of DLTI alerts.

Methods

A survey was designed with six predefined clinical cases selected from the clinical laboratory practice with a potential DLTI. Physicians from several departments, including internal medicine, cardiology, intensive care, surgery and geriatrics in six participating hospitals were recruited to fill in the survey. The survey addressed their knowledge of DLTIs, motivation to receive an alert and opinion on the potential influence on medical decision making.

Results

A total of 210 physicians completed the survey. Of these respondents 93% had a positive attitude towards receiving DLTI alerts; however, the reported value differed per case and per respondent’s background. In each clinical case, medical decision making was influenced as a consequence of the reported DLTI message (ranging from 3 to 45% of respondents per case).

Conclusions

In this multicentre survey, most physicians stated DLTI messages to be useful in laboratory test interpretation. Medical decision making was influenced by reporting DLTI alerts in each case. Alerts should be adjusted according to the needs and preferences of the receiving physicians.

Keywords: clinical laboratory test; (computerized) clinical decision support; diagnostic error; drug-laboratory test interaction; patient safety
Corresponding author: Jasmijn A. van Balveren, MSc, Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, Henri Dunantstraat 1, PO Box 90153, ’s-Hertogenbosch, Den Bosch, The Netherlands; and Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands, Phone: +31 (0)73-553 27 64, Fax: +31 (0)73-5532958, E-mail:

Funding source: Stichting Kwaliteitsgelden Medisch Specialisten (SKMS)

Award Identifier / Grant number: 42678870

Acknowledgments

We thank all the respondents for their time to complete the survey.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2020-1770).

Received: 2020-11-30
Accepted: 2021-02-15
Published Online: 2021-02-25
Published in Print: 2021-06-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2020-1770
Keywords for this article
clinical laboratory test; (computerized) clinical decision support; diagnostic error; drug-laboratory test interaction; patient safety

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Machine learning and coagulation testing: the next big thing in hemostasis investigations?
  4. Reviews
  5. Updates on liquid biopsy: current trends and future perspectives for clinical application in solid tumors
  6. The underestimated issue of non-reproducible cardiac troponin I and T results: case series and systematic review of the literature
  7. Opinion Paper
  8. Benefits, limitations and controversies on patient-based real-time quality control (PBRTQC) and the evidence behind the practice
  9. Genetics and Molecular Diagnostics
  10. ctDNA from body fluids is an adequate source for EGFR biomarker testing in advanced lung adenocarcinoma
  11. General Clinical Chemistry and Laboratory Medicine
  12. Incidence, characteristics and outcomes among inpatient, outpatient and emergency department with reported high critical serum potassium values
  13. Clinical usefulness of drug-laboratory test interaction alerts: a multicentre survey
  14. Integrating quality assurance in autoimmunity: the changing face of the automated ANA IIF test
  15. Plasma thiol/disulphide homeostasis changes in patients with restless legs syndrome
  16. Reference Values and Biological Variations
  17. High-resolution pediatric reference intervals for 15 biochemical analytes described using fractional polynomials
  18. Continuous reference intervals for leukocyte telomere length in children: the method matters
  19. Hematology and Coagulation
  20. Using machine learning to identify clotted specimens in coagulation testing
  21. Cardiovascular Diseases
  22. Long term pronostic value of suPAR in chronic heart failure: reclassification of patients with low MAGGIC score
  23. Infectious Diseases
  24. Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units
  25. A low level of CD16pos monocytes in SARS-CoV-2 infected patients is a marker of severity
  26. Thrombin generation in patients with COVID-19 with and without thromboprophylaxis
  27. Corrigendum
  28. Applying the concept of uncertainty to the sFlt-1/PlGF cut-offs for diagnosis and prognosis of preeclampsia
  29. Letters to the Editors
  30. Additional approaches for identifying non-reproducible cardiac troponin results
  31. Paediatric reference intervals for ionised calcium – a data mining approach
  32. A case of interference in testosterone, DHEA-S and progesterone measurements by second generation immunoassays
  33. Lack of cross-reactivity between anti-A IgG isoagglutinins and anti-SARS-CoV-2 IgG antibodies
  34. Artefactual bands on urine protein immunofixation gels
  35. A case of methaemoglobinaemia interference on the WDF channel on Sysmex XN-Series analysers
  36. Soluble fms-like tyrosine kinase-1: a potential early predictor of respiratory failure in COVID-19 patients
  37. Serendipitous detection of α1-antitrypsin deficiency: a single institution’s experience over a 32 month period
  38. The activated partial thromboplastin time may not reveal even severe fibrinogen deficiency
  39. Influence of C-reactive protein on thrombin generation assay
  40. Inappropriate extrapolations abound in fecal microbiota research
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