(STAR-DDI)- STandArdised consensus-based Reporting checklist foR Drug–Drug Interaction checkers and databases

<title>Abstract</title> <p> <bold>Purpose:</bold> To develop the STandArdised consensus-based Reporting checklist foR Drug–Drug Interaction checkers and databases (STAR-DDI), defining minimum reporting requirements to improve the transparency, consistency, and interpretability of drug–drug interaction (DDI) resources. <bold>Methods:</bold> Candidate items were derived from a systematic review and refined by a multidisciplinary steering committee and pilot survey. An anonymous, international, four-round modified Delphi study was conducted between September 2025 and April 2026. Participants included clinicians, researchers, drug-interaction specialists, guideline developers, and other stakeholders. Items were iteratively revised using quantitative ratings and free-text feedback. Consensus was defined a priori as ≥ 75% agreement or disagreement, with stability assessed across rounds. <bold>Results:</bold> The Delphi rounds included 29 participants in Round 1, 16 in each of Rounds 2 and 3, and 14 in Round 4. The process progressively refined the candidate items, particularly by separating DDI severity from clinical management and prioritising methodological rigour and study design over the quantity of evidence. In the final round, all 18 checklist items reached consensus, with agreement ranging from 85.7% to 100%. The final checklist covers title and abstract reporting, background and rationale, evidence sources and study-specific requirements, data curation and algorithms, database characteristics, system modifications, summary and future directions, supplementary resources, and funding and conflicts of interest. <bold>Conclusion:</bold> STAR-DDI provides a consensus-based minimum reporting framework for DDI checkers and databases. Its adoption may improve transparency, comparability, credibility, and clinical interpretation of DDI resources. Future research should assess its feasibility, usability, and impact on reporting quality. <bold>Introduction</bold> Adverse drug events (ADEs) associated with medication use contribute substantially to the burden of hospitalisations, accounting for more than 18% of all hospital admissions annually. ¹ Approximately one-third of ADEs are associated to drug–drug interactions (DDIs), which may account for up to 30% of adverse events. ² Several factors increase the risk of DDIs, including concomitant medication use (polypharmacy, commonly defined as the use of five or more medications), ³ and multimorbidity. ⁴ </p>