Impact of interactions between drugs and laboratory test results on diagnostic test interpretation – a systematic review

Jasmijn A. van Balveren 1 , Wilhelmine P.H.G. Verboeket-van de Venne 2 , Lale Erdem-Eraslan 3 , Albert J. de Graafhttp://orcid.org/https://orcid.org/0000-0001-5451-3010 4 , Annemarieke E. Loot 5 , Ruben E.A. Musson 6 , Wytze P. Oosterhuis 2 , Martin P. Schuijt 7 , Heleen van der Sijs 8 , Rolf J. Verheul 9 , Holger K. de Wolf 10 , Ron Kusters 11 , 12 , Rein M.J. Hoedemakers 11 ,  and on behalf of the Dutch Society for Clinical Chemistry and Laboratory Medicine, task group ‘SMILE’: Signaling Medication Interactions and Laboratory test Expert system
  • 1 Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, Henri Dunantstraat 1, PO Box 90153, ’s-Hertogenbosch, The Netherlands
  • 2 Department of Clinical Chemistry, Zuyderland Medical Centre, Heerlen, The Netherlands
  • 3 Department of Clinical Chemistry, Erasmus University Medical Centre, Rotterdam, The Netherlands
  • 4 Department of Clinical Chemistry, Medical Spectrum Twente, Enschede, The Netherlands
  • 5 Department of Clinical Chemistry, Certe, Groningen, The Netherlands
  • 6 Laboratory for Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands
  • 7 Department of Clinical Chemistry, Slingeland Hospital, Doetinchem, The Netherlands
  • 8 Department of Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, The Netherlands
  • 9 Department of Clinical Chemistry, LabWest/HMC Westeinde, The Hague, The Netherlands
  • 10 Department of Clinical Chemistry, Rivierenland Hospital, Tiel, The Netherlands
  • 11 Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, ’s-Hertogenbosch, The Netherlands
  • 12 Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
Jasmijn A. van Balveren
  • Corresponding author
  • Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, Henri Dunantstraat 1, PO Box 90153, ’s-Hertogenbosch, The Netherlands
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, Wilhelmine P.H.G. Verboeket-van de Venne
  • Department of Clinical Chemistry, Zuyderland Medical Centre, Heerlen, The Netherlands
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, Lale Erdem-Eraslan
  • Department of Clinical Chemistry, Erasmus University Medical Centre, Rotterdam, The Netherlands
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, Albert J. de GraafORCID iD: https://orcid.org/0000-0001-5451-3010, Annemarieke E. Loot, Ruben E.A. Musson
  • Laboratory for Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands
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, Wytze P. Oosterhuis
  • Department of Clinical Chemistry, Zuyderland Medical Centre, Heerlen, The Netherlands
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, Martin P. Schuijt
  • Department of Clinical Chemistry, Slingeland Hospital, Doetinchem, The Netherlands
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, Heleen van der Sijs
  • Department of Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, The Netherlands
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, Rolf J. Verheul
  • Department of Clinical Chemistry, LabWest/HMC Westeinde, The Hague, The Netherlands
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, Holger K. de Wolf, 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
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, Rein M.J. Hoedemakers
  • Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, ’s-Hertogenbosch, The Netherlands
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Abstract

Intake of drugs may influence the interpretation of laboratory test results. Knowledge and correct interpretation of possible drug-laboratory test interactions (DLTIs) is important for physicians, pharmacists and laboratory specialists. Laboratory results may be affected by analytical or physiological effects of medication. Failure to take into account the possible unintended influence of drug use on a laboratory test result may lead to incorrect diagnosis, incorrect treatment and unnecessary follow-up. The aim of this review is to give an overview of the literature investigating the clinical impact and use of DLTI decision support systems on laboratory test interpretation. Particular interactions were reported in a large number of articles, but they were fragmentarily described and some papers even reported contradictory findings. To provide an overview of information that clinicians and laboratory staff need to interpret test results, DLTI databases have been made by several groups. In a literature search, only four relevant studies have been found on DLTI decision support applications for laboratory test interpretation in clinical practice. These studies show a potential benefit of automated DLTI messages to physicians for the correct interpretation of laboratory test results. Physicians reported 30–100% usefulness of DLTI messages. In one study 74% of physicians sometimes even refrained from further additional examination. The benefit of decision support increases when a refined set of clinical rules is determined in cooperation with health care professionals. The prevalence of DLTIs is high in a broad range of combinations of laboratory tests and drugs and these frequently remain unrecognized.

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Clinical Chemistry and Laboratory Medicine ( CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor of over three. CCLM is the official journal of nine national clinical societies and associated with EFLM.

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