Reducing drug–herb interaction risk with a computerized reminder system

BACKGROUND Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug-herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. METHODS Hospital computer systems are modified to ensure that drug-herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. RESULTS During the 2011-2013 study period, 256 patients received 891 herbal prescriptions with potential drug-herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). CONCLUSION Drug-herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug-herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions.