Impact of clinical decision support software on the prevalence of drug-drug interactions in an emergency ward: A pre-post study

Background Drug interactions present significant challenges in emergency departments due to the diverse patient population and the complexity of their conditions, which threaten patient safety and increase healthcare costs. Preventive strategies, such as real-time decision support systems, are essential for alerting physicians to potential medication risks. Methods A pre-post study was conducted in the emergency department of Ghaem Hospital in Mashhad. Phase 1 (June–August 2024) analyzed drug interactions for 482 patients using Lexidrug 2024. Phase 2 (October–December 2024) assessed 482 patients using new software, Ideapardazan Asr Hoshmand Etminan. Weekly interaction reports were shared with physicians. Major interactions, including Category X (life-threatening) and Category D (clinically significant), were compared using SPSS version 12. Results Phase 1 recorded 42 Category X and 118 Category D interactions. Phase 2 showed reductions to 32 Category X (P = 0.276) and 45 Category D (P < 0.01). Overall interactions decreased, but this change was not statistically significant (P = 0.759). There were no differences in prescriptions between academic and non-academic specialists. Conclusion The software reduced clinically significant interactions, demonstrating its potential to enhance medication safety. However, persistent challenges, such as alert fatigue and the lack of notable reductions in life-threatening interactions, highlight the need to prioritize critical alerts. Further research should focus on optimizing usability and integrating the software more effectively into clinical workflows.