MIMS cVm (Complementary Vs Mainstream) drug interactions module
The development of the interactions data base, headed up by Professor Basil Roufogalis and Professor Andrew McLachlan and has been updated and expanded since its inception in 2002.

The interaction record contains a description of the interaction, what could be expected if there is an interaction, severity of the interaction, strength of the supporting evidence and precautions needed. This helps the healthcare professional and, eventually, the patient to avoid adverse events.

The IMgateway database within eMIMS will enable health professionals to retrieve evidence-based information on clinically-significant drug and herb interactions. Enabling a search of a complementary medicine against a prescription medicine (or vice-versa), to quickly obtain a recommendation on whether the combination should be avoided or requires caution.

The new database makes clinical recommendations on the significance of herb-drug interactions based on the National Health and Medical Research Council's levels of evidence scale.

By selecting a prescribed medicine and a herbal product this module will display all known interactions according to the evidence based work done by the team at Sydney University.  For each result of the drug herb function, there is an ‘at-a-glance’ commentary on the evidence, a severity rating* advice to the patient which includes the detail of the interaction, and all the relevant references should you require further information.

IMgateway drug interaction data is available within eMIMS as an additional subscription. For more information about this subscription please call our client services team on 1800 800 629.

This extensive database of drug interactions is constantly reviewed and updated, and is currently only available in eMIMS where the updates will be available each month.

Key features include:

• Locally researched, evidence based drug herb interactions
• Makes clinical recommendations on the significance of herb-drug interactions based on the National Health and Medical Research Council's levels of evidence scale
• Drug herb interactions are constantly reviewed and updated
• Full referenced
• A unique database because it is based on the Australian market

It is important to note that, where there are Drug Herb Interactions in both IMgateway and MIMS, both interactions information will be shown.  The following disclaimer will guide you on how to evaluate the information presented.

*Severity ratings Disclaimer
This interaction has both a MIMS and IMgateway result. The principles of the severity ratings used by IMgateway and MIMS are different. Please ensure you read all of the information about these interactions and do not rely on the severity level alone to make your clinical decision.

Strategy
The editorial team meets periodically to review the overall approach and consider specific elements of the herb-drug interaction database. The focus of these meetings is on the scope, content and relevance of the monographs and the manner in which the data are presented and discussed. At these meetings the editorial team would also consider the response to any feedback received on the database.

Process: Search, write and review
On a weekly basis, a Research Pharmacist from the University of Sydney carries out an extensive literature search to identify new herb-drug interactions and update existing herb-drug interactions with the most recent, up-to-date literature. Based on a critical analysis of the available literature for a specific herb-drug interaction, the Research Pharmacist drafts the 'Advice for the patient' and 'Commentary on evidence' sections of the interaction monograph, and provides a draft general recommendation for the interaction.

The interaction monograph is then editorially reviewed and approved (after any amendments) by a senior member of the editorial team at the Faculty of Pharmacy, University of Sydney. The process of review focusses on the nature and quality of the evidence and clinical relevance of the potential interaction. Monographs are always written from an international perspective.

Critical appraisal
Central to the inclusion of any data in herb-drug interactions in the database is the process of careful critical appraisal of the published studies from international literature. This process is facilitated by documents such as the CONSORT statement on reporting randomized, controlled trials of herbal interventions (Gagnier et al, 2006) and the NHMRC hierarchy of assessing evidence.

The Editorial team
The writing and review team is made up of researchers with specific experience in clinical practice, pharmaceutical industry, scientific evaluation of herbal medicines, herbal medicines clinical research (including investigation of herb-drug interactions), clinical pharmacology, scholarly publication, peer review and biopharmaceutics. Taken together, this skill mix provides the best opportunity to develop high quality monographs of herb-drug interactions that have relevance to guide clinical practice.

Reference : Gagnier JJ, Boon H, Rochon P, Moher D, Barnes J, Bombardier C. Reporting randomized, controlled trials of herbal interventions: an elaborated CONSORT statement. Ann Intern Med 2006; 144(5):364-367

This “Australian Made” evidence based, drug herb interaction database is available in eMIMS.

For further information please contact our Client Services Team on 1800 800 629 or email info@mims.com.au