Design and Implementation of a Dashboard for Drug Interactions Mediated by Cytochromes Using a Health Care Data Warehouse in a University Hospital Center: Development Study
The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first dru...
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| Abstract | The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions.
This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts.
The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out.
The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively.
At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. |
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| AbstractList | The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions.
This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts.
The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out.
The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively.
At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions.BackgroundThe enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions.This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts.ObjectiveThis study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts.The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out.MethodsThe initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out.The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively.ResultsThe development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively.At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software.ConclusionsAt our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. Background:The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions.Objective:This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts.Methods:The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out.Results:The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively.Conclusions:At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. Abstract BackgroundThe enzymatic system of cytochrome P450 (CYP450 ObjectiveThis study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts. MethodsThe initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the (CYP450 ResultsThe development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4CYP3A5 ConclusionsAt our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. Abstract Background The enzymatic system of cytochrome P450 ( CYP450 ) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances of underdosing of drugs due to the concurrent administration of another drug that strongly induces the same cytochrome for which the first drug is a substrate and overdosing due to strong inhibition. IT solutions have been proposed to raise awareness among prescribers to mitigate these interactions. Objective This study aimed to develop a drug interaction dashboard for Cytochrome-mediated drug interactions (DIDC) using a health care data warehouse to display results that are easily readable and interpretable by clinical experts. Methods The initial step involved defining requirements with expert pharmacologists. An existing model of interactions involving the ( CYP450 ) was used. A program for the automatic detection of cytochrome-mediated drug interactions (DI) was developed. Finally, the development and visualization of the DIDC were carried out by an IT engineer. An evaluation of the tool was carried out. Results The development of the DIDC was successfully completed. It automatically compiled cytochrome-mediated DIs in a comprehensive table and provided a dedicated dashboard for each potential DI. The most frequent interaction involved paracetamol and carbamazepine with CYP450 3A4 (n=50 patients). The prescription of tacrolimus with CYP3A5 genotyping pertained to 675 patients. Two experts qualitatively evaluated the tool, resulting in overall satisfaction scores of 6 and 5 out of 7, respectively. Conclusions At our hospital, measurements of molecules that could have altered concentrations due to cytochrome-mediated DIs are not systematic. These DIs can lead to serious clinical consequences. The purpose of this DIDC is to provide an overall view and raise awareness among prescribers about the importance of measuring concentrations of specific drugs and metabolites. Ultimately, the tool could lead to an individualized approach and become a prescription support tool if integrated into prescription assistance software. |
| Author | Eyer, Kevin Darmoni, Stefan Wils, Julien Grosjean, Julien Gosselin, Laura Disson, Flavien Dahamna, Badisse Maes, Alexandre |
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| Cites_doi | 10.3233/SHTI190339 10.1016/j.ejps.2023.106405 10.1016/j.dmpk.2019.11.006 10.1186/s12911-022-01762-4 10.1517/17425255.2011.611501 10.1093/database/baab057 10.1007/s40272-018-0302-4 10.1016/j.ijmedinf.2022.104976 10.4155/fmc.12.197 10.1093/nar/gkx1037 10.1177/10781552211029046 10.1007/s43188-020-00056-z 10.1136/amiajnl-2013-002538 10.1161/CIRCOUTCOMES.122.009256 10.1080/03602532.2020.1765792 10.1186/s12911-020-1084-5 |
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| Copyright | Laura Gosselin, Alexandre Maes, Kevin Eyer, Badisse Dahamna, Flavien Disson, Stefan Darmoni, Julien Wils, Julien Grosjean. Originally published in JMIR Medical Informatics (https://medinform.jmir.org). 2024. This work is licensed under https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. licence_http://creativecommons.org/publicdomain/zero Copyright © Laura Gosselin, Alexandre Maes, Kevin Eyer, Badisse Dahamna, Flavien Disson, Stefan Darmoni, Julien Wils, Julien Grosjean. Originally published in JMIR Medical Informatics (https://medinform.jmir.org) 2024 |
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| Keywords | information system development pharmaceutical visualization drugs medication develop warehousing warehouse personalized medicine cytochrome pharmacotherapy design pharmacology interaction pharmaceutic pharmacy adverse drug-drug interaction dashboard |
| Language | English |
| License | Laura Gosselin, Alexandre Maes, Kevin Eyer, Badisse Dahamna, Flavien Disson, Stefan Darmoni, Julien Wils, Julien Grosjean. Originally published in JMIR Medical Informatics (https://medinform.jmir.org). licence_http://creativecommons.org/publicdomain/zero/: http://creativecommons.org/publicdomain/zero This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on https://medinform.jmir.org/, as well as this copyright and license information must be included. |
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| References | Satyam (R13); 2021 Wishart (R8); 46 Teixeira (R15); 264 Gu (R6); 28 Mishra (R10); 7 Pressat-Laffouilhère (R20); 22 Dorsch (R14); 16 R21 R23 R22 R25 R24 Guengerich (R2); 37 R26 Gosselin (R18); 170 Simpao (R11); 22 R1 R3 R7 Li (R17); 184 Grosjean (R19); 166 Jeffries (R12); 20 Jaladanki (R5); 52 Kato (R9); 35 Ortiz de Montellano (R4); 5 Iapadre (R16); 20 |
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| Snippet | The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records instances... Background:The enzymatic system of cytochrome P450 (CYP450) is a group of enzymes involved in the metabolism of drugs present in the liver. Literature records... Abstract Background The enzymatic system of cytochrome P450 ( CYP450 ) is a group of enzymes involved in the metabolism of drugs present in the liver.... Abstract BackgroundThe enzymatic system of cytochrome P450 (CYP450 ObjectiveThis study aimed to develop a drug interaction dashboard for Cytochrome-mediated... |
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| SubjectTerms | Adverse Drug Events Detection, Pharmacovigilance and Surveillance Automation Case Study Computer Science Cytochrome Cytochrome P-450 Enzyme System - metabolism Data processing Data warehouses Data Warehousing Decision Support for Health Professionals Design Drug dosages Drug Interactions Electronic Health Records Enzymes Genomics and Bioinformatics for Clinical Use Health care Hospitals, University Human subjects Humans Information Retrieval Life Sciences Medication Metabolism Metabolites Metadata Morphine Multilingualism Ontology Original Paper Pharmaceutical sciences Prescription drugs Quality Improvement Queries Questionnaires Tools, Programs and Algorithms Toxicity Visualization |
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| Title | Design and Implementation of a Dashboard for Drug Interactions Mediated by Cytochromes Using a Health Care Data Warehouse in a University Hospital Center: Development Study |
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