Evaluation of eight drug interaction databases commonly used in the German healthcare system

Objectives The aim of the study was to determine the best database regarding accuracy, comprehensiveness and user-friendliness out of eight German and International databases. Methods Accuracy, comprehensiveness and ease of use of ABDA-database (ABDA), MediQ, Pharmavista, MMI Pharmindex, AiDKlinik (AIK), Lexi-Interact (LI), Epocrates and drugs.com were evaluated using 50 clinically relevant and 50 non-relevant drug interaction pairs. Accuracy was determined investigating sensitivity, specificity and positive and negative predictive values. Comprehensiveness was rated according to monograph components. Ease of use was evaluated by the time needed to assess the management of 10 clinically relevant interactions. The main outcome measure was the Total Score (TS) (max. 312.5 points) obtained by adding the specifically weighted points for accuracy, comprehensiveness and ease of use. Results LI ranked first in TS (243/312.5 points), followed by AIK (229/312.5 points). All databases showed high sensitivity. However, they had difficulties in clearly classifying an interaction as non-relevant, reflected in a low specificity. ABDA ranked first in accuracy because it dealt best with this problem. LI provided the most detailed monographs, reflected in a high Comprehensiveness Score. Results for comprehensiveness varied greatly, as the databases are designed for different needs. This also applied to Ease of Use Score, where AIK performed best. Conclusions LI proved to be the most recommendable database in our evaluation due to its superior comprehensiveness. All databases scored rather well on accuracy, but showed a tendency towards over-alerting.