{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:33:39Z","timestamp":1789187619128,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012774","name":"Innovationsfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012774","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF17OC0027594"],"award-info":[{"award-number":["NNF17OC0027594"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF14CC0001"],"award-info":[{"award-number":["NNF14CC0001"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>While the beneficial effects of medications are numerous, drug\u2013drug interactions may lead to adverse drug reactions that are preventable causes of morbidity and mortality. Our goal was to quantify the prevalence of potential drug\u2013drug interactions in drug prescriptions at Danish hospitals, estimate the risk of adverse outcomes associated with discouraged drug combinations, and highlight the patient types (defined by the primary diagnosis of the admission) that appear to be more affected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional (descriptive part) and cohort study (adverse outcomes part) used hospital electronic health records from two Danish regions (~2.5 million people) from January 2008 through June 2016. We included all inpatients receiving two or more medications during their admission and considered concomitant prescriptions of potentially interacting drugs as per the Danish Drug Interaction Database. We measured the prevalence of potential drug\u2013drug interactions in general and discouraged drug pairs in particular during admissions and associations with adverse outcomes: post\u2010discharge all\u2010cause mortality rate, readmission rate and length\u2010of\u2010stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2\u2009886\u2009227 hospital admissions (945\u2009475 patients; median age 62\u2009years [IQR: 41\u201374]; 54% female; median number of drugs 7 [IQR: 4\u201311]), patients in 1\u2009836\u2009170 admissions were exposed to at least one potential drug\u2013drug interaction (659\u2009525 patients; median age 65\u2009years [IQR: 49\u201377]; 54% female; median number of drugs 9 [IQR: 6\u201313]) and in 27\u2009605 admissions to a discouraged drug pair (18\u2009192 patients; median age 68\u2009years [IQR: 58\u201377]; female 46%; median number of drugs 16 [IQR: 11\u201322]). Meropenem\u2010valproic acid (HR: 1.5, 95% CI: 1.1\u20131.9), domperidone\u2010fluconazole (HR: 2.5, 95% CI: 2.1\u20133.1), imipramine\u2010terbinafine (HR: 3.8, 95% CI: 1.2\u201312), agomelatine\u2010ciprofloxacin (HR: 2.6, 95% CI: 1.3\u20135.5), clarithromycin\u2010quetiapine (HR: 1.7, 95% CI: 1.1\u20132.7) and piroxicam\u2010warfarin (HR: 3.4, 95% CI: 1\u201311.4) were associated with elevated mortality. Confidence interval bounds of pairs associated with readmission were close to 1; length\u2010of\u2010stay results were inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Well\u2010described potential drug\u2013drug interactions are still missed and alerts at point of prescription may reduce the risk of harming patients; prescribing clinicians should be alert when using strong inhibitor\/inducer drugs (i.e. clarithromycin, valproic acid, terbinafine) and prevalent anticoagulants (i.e. warfarin and non\u2010steroidal anti\u2010inflammatory drugs \u2010 NSAIDs) due to their great potential for dangerous interactions. The most prominent CYP isoenzyme involved in mortality and readmission rates was 3A4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.5415","type":"journal-article","created":{"date-parts":[[2022,2,6]],"date-time":"2022-02-06T07:48:02Z","timestamp":1644133682000},"page":"632-642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Drug interactions in hospital prescriptions in Denmark: Prevalence and associations with adverse outcomes"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3133-0630","authenticated-orcid":false,"given":"Cristina","family":"Leal Rodr\u00edguez","sequence":"first","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-0371","authenticated-orcid":false,"given":"Benjamin Skov","family":"Kaas\u2010Hansen","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"},{"name":"Clinical Pharmacology Unit Zealand University Hospital  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-6456","authenticated-orcid":false,"given":"Robert","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Pulmonary and Infectious Diseases Nordsj\u00e6llands Hospital  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3125-2951","authenticated-orcid":false,"given":"Jorge Hernansanz","family":"Biel","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-1948","authenticated-orcid":false,"given":"Kirstine G.","family":"Belling","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1914-4720","authenticated-orcid":false,"given":"Stig Ejdrup","family":"Andersen","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Unit Zealand University Hospital  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-5866","authenticated-orcid":false,"given":"S\u00f8ren","family":"Brunak","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Stockley's Drug Interactions","author":"Baxter K","year":"2010"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0322-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1996.tb01865.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-002-0557-z"},{"key":"e_1_2_11_6_1","volume-title":"Appl. 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