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Katanić J, Stanimirov B, Sekeruš V, Đanić M, Pavlović N, Mikov M, Stankov K. Drug interference with biochemical laboratory tests. Biochem Med (Zagreb) 2023; 33:020601. [PMID: 37143715 PMCID: PMC10152617 DOI: 10.11613/bm.2023.020601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/21/2023] [Indexed: 05/06/2023] Open
Abstract
Clinical laboratory practice represents an essential part of clinical decision-making, as it influences 60-70% of medical decisions at all levels of health care. Results of biochemical laboratory tests (BLTs) have a key role in establishment of adequate diagnosis as well as in evaluation of treatment progress and outcome. The prevalence of drug-laboratory test interactions (DLTIs) is up to 43% of patients who had laboratory results influenced by drugs. Unrecognized DLTIs may lead to misinterpreted BLTs results, incorrect or delayed diagnosis, extra costs for unnecessary additional tests or inadequate therapy, as all may cause false clinical decisions. The significance of timely and adequate recognition of DLTIs is to prevent common clinical consequences such as incorrectly interpreted test results, delayed or non-treated condition due to erroneous diagnosis or unnecessary extra tests or therapy. Medical professionals should be educated that it is essential to obtain patient data about medications especially for the drugs used in the last 10 days before biological material collection. Our mini-review aims to provide a comprehensive overview of the current state in this important domain of medical biochemistry with detailed analysis of the effect of drugs on BLTs and to give detailed information to medical specialists.
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Affiliation(s)
- Jasmina Katanić
- Department of Biochemistry, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Bojan Stanimirov
- Department of Biochemistry, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Vanesa Sekeruš
- Department of Biochemistry, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Maja Đanić
- Department of Pharmacology, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Nebojša Pavlović
- Department of Pharmacy, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Momir Mikov
- Department of Pharmacology, Medical faculty, University of Novi Sad, Novi Sad, Serbia
| | - Karmen Stankov
- Department of Biochemistry, Medical faculty, University of Novi Sad, Novi Sad, Serbia
- Corresponding author:
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van Balveren JA, Verboeket-van de Venne WPHG, Doggen CJM, Cornelissen AS, Erdem-Eraslan L, de Graaf AJ, Krabbe JG, Musson REA, Oosterhuis WP, de Rijke YB, van der Sijs H, Tintu AN, Verheul RJ, Hoedemakers RMJ, Kusters R. Clinical usefulness of drug-laboratory test interaction alerts: a multicentre survey. Clin Chem Lab Med 2021; 59:1239-1245. [PMID: 33645171 DOI: 10.1515/cclm-2020-1770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/15/2021] [Indexed: 11/15/2022]
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.
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Affiliation(s)
- Jasmijn A van Balveren
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, Den Bosch, The Netherlands.,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | | | - Carine J M Doggen
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Anne S Cornelissen
- Department of Clinical Chemistry and Laboratory Medicine, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Lale Erdem-Eraslan
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert J de Graaf
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ruben E A Musson
- Laboratory for Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wytze P Oosterhuis
- Department of Clinical Chemistry, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Heleen van der Sijs
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrei N Tintu
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Rolf J Verheul
- Department of Clinical Chemistry and Laboratory Medicine, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Rein M J Hoedemakers
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, Den Bosch, The Netherlands
| | - Ron Kusters
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, Den Bosch, The Netherlands.,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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van Balveren JA, Verboeket-van de Venne WPHG, Erdem-Eraslan L, de Graaf AJ, Loot AE, Musson REA, Oosterhuis WP, Schuijt MP, van der Sijs H, Verheul RJ, de Wolf HK, Kusters R, Hoedemakers RMJ. Diagnostic error as a result of drug-laboratory test interactions. Diagnosis (Berl) 2019; 6:69-71. [PMID: 30753158 DOI: 10.1515/dx-2018-0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/28/2019] [Indexed: 11/15/2022]
Abstract
Background Knowledge of possible drug-laboratory test interactions (DLTIs) is important for the interpretation of laboratory test results. Test results may be affected by physiological or analytical drug effects. Failure to recognize these interactions may lead to misinterpretation of test results, a delayed or erroneous diagnosis or unnecessary extra tests or therapy, which may harm patients. Content Thousands of interactions have been reported in the literature, but are often fragmentarily described and some papers even reported contradictory findings. How can healthcare professionals become aware of all these possible interactions in their individual patients? DLTI decision support applications could be a good solution. In a literature search, only four relevant studies have been found on DLTI decision support applications in clinical practice. These studies show a potential benefit of automated DLTI messages to physicians for the interpretation of laboratory test results. All physicians reported that part of the DLTI messages were useful. In one study, 74% of physicians even sometimes refrained from further additional examination. Summary and outlook Unrecognized DLTIs potentially cause diagnostic errors in a large number of patients. Therefore, efforts to avoid these errors, for example with a DLTI decision support application, could tremendously improve patient outcome.
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Affiliation(s)
- Jasmijn A van Balveren
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | | | - Lale Erdem-Eraslan
- Department of Clinical Chemistry, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Albert J de Graaf
- Department of Clinical Chemistry, Medical Spectrum Twente, Enschede, The Netherlands
| | | | - Ruben E A Musson
- Laboratory for Clinical Chemistry and Haematology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Wytze P Oosterhuis
- Department of Clinical Chemistry, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Martin P Schuijt
- Department of Clinical Chemistry, Slingeland Hospital, Doetinchem, The Netherlands
| | - Heleen van der Sijs
- Department of Hospital Pharmacy, Erasmus Medical Centre, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Rolf J Verheul
- Department of Clinical Chemistry, LabWest/HMC Westeinde, The Hague, The Netherlands
| | - Holger K de Wolf
- Department of Clinical Chemistry, Rivierenland Hospital, Tiel, The Netherlands
| | - Ron Kusters
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.,Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Rein M J Hoedemakers
- Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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