Evaluation of drug information resources for interactions between therapeutic drugs and drugs of abuse


  • Robert D. Beckett Drug Information Center, Manchester University, Fort Wayne, IN
  • Jennifer R. Martin Health Sciences Library, University of Arizona, Tucson, AZ
  • Curtis D. Stump Pharmacy Program, Manchester University, Fort Wayne, IN
  • Megan A. Dyer Pharmacy Program, Manchester University, Fort Wayne, IN




Drug Interactions, Drug Information, Evaluation Studies


Objective: The research evaluated point-of-care resources for scope, completeness, and consistency of information describing interactions between therapeutic drugs and drugs of abuse (DoA).

Methods: A cross-sectional evaluation study was conducted focusing on seven resources: Clinical Pharmacology, Facts & Comparisons eAnswers, Lexicomp Online, Micromedex, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley’s Drug Interactions. A sample of clinically relevant interactions was developed through review of tertiary literature and resources, and input was solicited from subject matter experts. Entries from each resource for each interaction were evaluated for scope (i.e., whether there was an entry for the interaction); completeness (i.e., whether there was information addressing mechanism; clinical effects, severity, course of action, and level of certainty, described as a median rating on a 5-point scale); and consistency (i.e., whether the information in the resource was similar to the majority) among resources with an entry.

Results: Following review by subject matter experts, the final sample contained 159 interactions. Scope scores ranged from 0.6% (Drug Interactions Analysis and Management) to 43.4% (Lexicomp Online). Completeness scores ranged from 2 (interquartile range [IQR] 0 to 3, Stockley’s Drug Interactions) to 5 (IQR 5 to 5, Drug Interaction Facts, Micromedex, Facts & Comparisons eAnswers). Consistency scores ranged from 30.8% (Stockley’s Drug Interactions) to 87.1% (Clinical Pharmacology) for severity and from 15.4% (Facts & Comparisons eAnswers) to 71.4% (Drug Interaction Facts) for course of action.

Conclusions: Although coverage of drug-DoA interactions was low and content was often inconsistent among resources, the provided information was generally complete.


Arellano AL, Papaseit E, Romaguera A, Torrens M, Farre M. Neuropsychiatric and general interactions of natural and synthetic cannabinoids with drugs of abuse and medicines. CNS Neurol Disord Drug Targets. 2017;16(5):554–-66. DOI: http://dx.doi.org/10.2174/1871527316666170413104516.

Pérez-Mañá C, Papaseit E, Fonseca F, Farré A, Torrens M, Farré M. Drug interactions with new synthetic opioids. Front Pharmacol. 2018 Oct;9:1145. DOI: http://dx.doi.org/10.3389/fphar.2018.01145.

Substance Abuse and Mental Health Services Administration Services (SAaMH). Key substance use and mental health indicators in the United States: results from the 2018 national survey on drug use and health [Internet]. Rockville, MD: The Administration; 2019 [cited 23 Oct 2019]. <https://www.samhsa.gov/data/report/2018-nsduh-annual-national-report>.

Wills S. Drugs of abuse. 2nd ed. Grayslake, IL: Pharmaceutical Press; 2015.

Abarca J, Malone DC, Armstrong EP, Grizzle AJ, Hansten PD, Van Bergen RC, Lipton RB. Concordance of severity ratings provided in four drug interaction compendia. J Am Pharm Assoc. 2004 Mar–Apr;44(2):136–41. DOI: http://dx.doi.org/10.1331/154434504773062582.

Malone DC, Abarca J, Hansten PD, Grizzle AJ, Armstrong EP, Van Bergen RC, Duncan-Edgar BS, Solomon SL, Lipton RB. Identification of serious drug-drug interactions: results of the partnership to prevent drug-drug interactions. J Am Pharm Assoc. 2004 Mar–Apr;44(2):142–51. DOI: http://dx.doi.org/10.1331/154434504773062591.

Patel RI, Beckett RD. Evaluation of resources for analyzing drug interactions. J Med Libr Assoc. 2016 Oct;104(4):290–5. DOI: http://dx.doi.org/10.3163/1536-5050.104.4.007.

Wagh BR, Godbole DD, Deshmukh SS, Iyer S, Deshpande PR. Identification and assessment of potential drug-drug interactions in intensive care unit patients. Indian J Crit Care Med. 2019 Apr;23(4):170–4. DOI: http://dx.doi.org/10.5005/jp-journals-10071-23147.

Beckett RD, Stump CD, Dyer MA. Evaluation of drug information resources for drug-ethanol and drug-tobacco interactions. J Med Libr Assoc. 2019 Jan;107(1):62–71. DOI: http://dx.doi.org/10.5195/jmla.2019.549.

Monteith S, Glenn T. A comparison of potential psychiatric drug interactions from six drug interaction database programs. Psychiatry Res. 2019 May;275:366–72. DOI: http://dx.doi.org/10.1016/j.psychres.2019.03.041.

Guy J, Portillo I, eds. Basic resources for pharmacy education [Internet]. Arlington, VA: American Association of Colleges of Pharmacy 2019 [rev. Jul 2019; cited 23 Jun 2020]. <https://connect.aacp.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=3d70ed16-cb20-c959-26fe-ddcd6f768c8d&forceDialog=0>.

Gold S, Elsevier. Clinical pharmacology drug interaction report [Internet]. Amsterdam, The Netherlands: Elsevier; 2019 [cited 30 Jul 2019]. <http://www.clinicalpharmacology-ip.com/Forms/Reports/intereport.aspx>.

Wolters Kluwer. Facts & Comparisons® eAnswers [Internet]. Indianapolis, IN: Wolters Kluwer [cited 30 Jul 2019]. <http://online.factsandcomparisons.com/>.

Wolters Kluwer. Lexicomp® Interactions [Internet]. Indianapolis, IN: Wolters Kluwer [cited 30 Jul 2019]. <http://online.lexi.com/lco/action/interact>.

IBM. Micromedex® Solutions Drug Interactions [Internet]. Armonk, NY: IBM [cited 30 Jul 2019]. <https://www.micromedexsolutions.com>.

Hansten PD, Horn JR. Drug interactions analysis and management. St. Louis, MO: Wolters Kluwer Health; 2014.

Tatro DS, ed. Drug interaction facts 2015. St. Louis, MO: Wolters Kluwer Health; 2014.

Baxter K, Preston CL, eds. Stockley’s drug interactions. London, UK: Pharmaceutical Press; 2016.

IBM Analytics I. SPSS Statistics. Version 24. Armonk, NY: IBM; 2016.

Peters LB, Bahr N, Bodenreider O. Evaluating drug-drug interaction information in NDF-RT and DrugBank. J Biomed Semantics. 2015 May;6:19. DOI: http://dx.doi.org/10.1186/s13326-015-0018-0.

Roblek T, Vaupotic T, Mrhar A, Lainscak M. Drug-drug interaction software in clinical practice: a systematic review. Eur J Clin Pharmacol. 2015 Feb;71(2):131–42. DOI: http://dx.doi.org/10.1007/s00228-014-1786-7.

Grizzle AJ, Horn J, Collins C, Schneider J, Malone DC, Stottlemyer B, Boyce RD. Identifying common methods used by drug interaction experts for finding evidence about potential drug-drug interactions: web-based survey. J Med Internet Res. 2019 Jan;21(1):e11182. DOI: http://dx.doi.org/10.2196/11182.






Original Investigation