(296) Primary Care Physicians’ Views on Drug Interaction Alerts – a Questionnaire Study

Background: Patients in primary care often have long medication lists and many potential drug-drug interactions; in Sweden most primary care physicians have access to drug interaction alerts through the electronic medical records. These alerts build upon the Janusmed knowledge resource and provide users with information and advice about potentially problematic interactions.

Objectives: To elucidate the views of primary care physicians on the usefulness of drug interaction alerts.

Methods: Descriptive analysis of data from a 4-page questionnaire that was distributed to 71 physicians specializing in general practice/family medicine, who attended an educational session in Borås, Sweden, November 2023. A clinical scenario was presented in the questionnaire – a 73-year old woman with 10 drugs in the medication list and 11 drug interaction alerts. Complete printouts of the corresponding Janusmed texts were provided, and respondents were asked what, if any, action they would take. A general question on the usefulness of the Janusmed advice, on a Likert scale from 1 = “completely disagree” to 5 = “completely agree”, was included, as well as a free-text question on respondents’ views concerning drug interaction alerts. The latter two questions are analysed here.

Results: In all, 69 physicians completed the questionnaire (response rate 97%), of which 44 (64%) were 31–40 years old, 38 (55%) medically educated in Sweden, and 33 (48%) female. Most 57 (83%) fully (Likert scale level 5) or almost fully (level 4) agreed that advice from Janusmed was useful for handling drug interactions when prescribing drug treatment.

Views on drug interaction alerts were provided by 23 (33%) respondents. Of these, 15 (65%) were positive and 5 (22%) somewhat critical. The physicians’ main concerns were that alerts could be overwhelming and difficult to accommodate into clinical work, particularly for older patients with many drugs. Further, advice on alternative treatment was sometimes lacking and it was difficult to relate studies referred to in Janusmed, to individual patients.

Conclusions: Swedish primary care physicians find decision support for drug interactions valuable in clinical practice, but there is an apparent risk of alert fatigue.