ArticlePloS one2026
Prevalence, predictors, and clinical relevance of drug-drug interactions in outpatient prescribing: A national cross-sectional study.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Health-system drivers of outpatient antibiotic use: evidence from prescribing, centralized supply, and catchment populations in public tertiary hospitals in Bihar, India.Frontiers in health services · 2026Article
- Healthcare utilization patterns and medication burden in post-COVID syndrome: a cross-sectional analysis reveals four phenotypes.Frontiers in health services · 2026Article
- Exploratory prescribing risk profiles and drug drug interaction burden in older adults with depressive episodes.Frontiers in psychiatry · 2026Article
- Exploratory cluster analysis of self-reported adverse events associated with antidepressants using Gower distance and partitioning around medoids: a single-center cross-sectional study.Frontiers in psychiatry · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrug-drug interactions (DDIs) represent a major preventable cause of medication-related harm globally. Their prevalence varies across health systems, but common drivers include polypharmacy, aging populations, and specialty-specific prescribing patterns. Large-scale pharmacoepidemiologic analyses of real-world prescription data can clarify the magnitude of the problem and inform strategies to reduce risks.
methodsThis retrospective study included 2,365,811 outpatient prescriptions (982,102 patients) from Tehran, Iran. The top 100 most prescribed medications were screened for potential DDIs via Micromedex®. Interactions were classified as contraindicated, major, or moderate. Logistic regression identified demographic, specialty, and prescription-level predictors.
resultsPotential DDIs occurred in 46.1% of prescriptions, with 57.8% of patients affected. Major DDIs (62.6%) dominated, followed by moderate (32.8%) and contraindicated (4.6%). ASA was a frequent contributor to high-risk pairs. Contraindicated interactions were largely NSAID duplications, most common in orthopedics and emergency medicine. Psychiatry and cardiology prescriptions showed the highest prevalence, while polypharmacy strongly predicted DDIs, with incremental risks amplified in older adults.
conclusionsOutpatient DDIs represent a substantial burden in routine care, comparable to international reports. Prevention requires comprehensive strategies, including e-prescribing with CDSS, pharmacist-led reviews, patient education on OTC use, and policy interventions to limit reimbursement of unsafe combinations.
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