The Effect Of Active Training In Reducing Severe Drug Interactions

Background: Medication errors are among the most important medical errors. Considering the current trend of poly-pharmacy and a high average number of drugs in prescriptions, drug interactions are of great significance.Purpose: To evaluate the effect of educational interventions including face-to-face, audit feedback and educational notes, among Gorgan physicians.Methods: With an initial estimation of 8% severe drug interactions (95% confidence level, 7% accuracy), the sample size was calculated to include at least 5600 prescriptions. After classifying the observed interactions and identifying the physicians, a questionnaire was prepared and completed attending their offices. Training was provided using face-to-face conversation, audit feedback and educational notes. After training on the severe interactions, physicians’ prescriptions were reviewed again after three months and the number of interactions was compared with that observed at baseline, to evaluate the effect of training.Data were classified, computerized and analyzed with SPSS-10 using Chi-square and McNemar tests. The interactions’ clinical importance was also evaluated using relative test.Results: Overall prevalence of drug interactions was 8.93%, of which 6.55% were major, 65.58% moderate and 27.87% minor. Interactions were mostly seen among male doctors. The physicians with an average drug number of more than 4 had significantly more interactions in their prescriptions. The majority of physicians with major drug interactions did not know their clinical significance. After training, there was a significant reduction in major drug interactions, but none in moderate and minor interactions for which no education was provided.Conclusion: Drug interactions are common medical errors in Gorgan province and training can decrease their rate.