Putting knowledge into practice: does information on adverse drug interactions influence people's dosing behavior?

Abstract

Objective: Adverse drug events relating to drug-drug interactions are a common cause of patient harm. Central to avoiding this harm is the patients’ understanding that certain drug combinations present a synergistic risk. Two studies tested whether providing individuals with information about a drug combination that presents a synergistic (cf. additive) risk would elicit higher perceived risk and, therefore, would result in greater precaution in terms of dosing behavior.

Design: Both studies employed an experimental design.

Methods: Participants were presented with a scenario describing how two symptoms of an infection could each be treated by a different drug. In Experiment 1, information about the effects of combining the two drugs was varied: (i) no information, (ii) combination elicits an additive risk, or (iii) combination elicits a synergistic risk. In Experiment 2, the size of the risk (small or large) and the participant’s role (patient or doctor) was also varied.

Results: In both experiments, perceived risk and negative affect increased in response to information about the increased probability of side effects from the drug-drug interaction. Despite these increases, participants did not adjust their drug dosing behavior in either experiment: dosing was similar when these interactions were large or small, or when they were due to synergistic or additive effects.

Conclusions: People may struggle to transfer their knowledge of drug-drug interaction risks into decision making behaviors. Care should be taken not to assume that holding accurate risk perceptions of a drugs side effect will result in decisions that help avoid adverse drug events.

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Identifiers

ORCID for Ian Dawson: orcid.org/0000-0003-0555-9682

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