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

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.

  1. Declaration of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors received financial support from the Quality Foundation of the Dutch Medical Specialists (SKMS).
  2. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
  3. Research funding: Quality Foundation of the Dutch Medical Specialists (SKMS), grant number: 42678870.
  4. Employment or leadership: None declared.
  5. Honorarium: None declared.
  6. Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-08-21 Accepted: 2018-09-21 Published Online: 2018-10-17 Published in Print: 2018-11-27

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