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Baraka MA, Elnaem MH, Elkalmi R, Sadeq A, Elnour AA, Joseph Chacko R, ALQarross AH, Moustafa MMA. Awareness of statin–food interactions using grapefruit as an example: a cross-sectional study in Eastern Province of Saudi Arabia. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objectives
The purpose of this study is to assess patients’ knowledge regarding statin–grapefruit interactions, to identify any pertinent demographic characteristics that may influence knowledge of this drug–food interaction, and to identify preferred patient sources of health information.
Methods
A cross-sectional study was conducted to collect data from statins users about the awareness regarding drug interaction with foods. Self-administered questionnaires have been distributed to collect data from statins users regardless of the type and the reason they administer these medications. Respondents were statins users visiting the King Fahd Hospital’s outpatient clinic (KFHU) and community pharmacies in the Eastern province of Saudi Arabia.
Key findings
Our study revealed that 62% of statin users never heard about the statin–grapefruit interaction. Only 11% have correctly recognized the interaction effect. Only 11, 21 and 6% of users have reported that they often/always received information on drug–food interaction from pharmacists, physicians and nurses, respectively. Users aged above 60 years had lower awareness than those aged <40 (6.0% vs. 14.1%). Similarly, the proportion was lower among users who had primary or lower educational attainment, unemployed or had income lower than 5000 SAR compared with that among the contrary groups. However, only income showed a statistically significant association (P = 0.007).
Conclusions
The majority of statin users have never heard about their interaction with food. Geriatrics, low-income and less educated patients had a lower level of awareness compared with their counterparts. Many patients may end up discontinuing their medications because of that interaction and the consequent side effects. Pharmacists are requested to play their expected role in providing adequate patient counselling to help improve patients’ awareness regarding safety concerns of statins medication.
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Affiliation(s)
- Mohamed A Baraka
- Program of Clinical Pharmacy, College of Pharmacy, Al Ain University – Al Ain Campus, Al Ain, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
- Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Ramadan Elkalmi
- Department of Pharmacology, Faculty of Medicine, Sabha University, Sabha, Libya
| | - Adel Sadeq
- Program of Clinical Pharmacy, College of Pharmacy, Al Ain University – Al Ain Campus, Al Ain, United Arab Emirates
| | - Asim Ahmed Elnour
- Program of Clinical Pharmacy, College of Pharmacy, Al Ain University – Abu Dhabi Campus, Abu Dhabi, United Arab Emirates
| | - Royes Joseph Chacko
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah H ALQarross
- Pharmacy Director of Al Zahra General Hospital Outpatient Pharmacy, Dammam, Saudi Arabia
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Prevalence and Clinical Significance of Drug-Drug and Drug-Dietary Supplement Interactions among Patients Admitted for Cardiothoracic Surgery in Greece. Pharmaceutics 2021; 13:pharmaceutics13020239. [PMID: 33572247 PMCID: PMC7914879 DOI: 10.3390/pharmaceutics13020239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Drug interactions represent a major issue in clinical settings, especially for critically ill patients such as those with cardiovascular disease (CVD) who require cardiothoracic surgery (CTS) and receive a high number of different medications. Methods: A cross-sectional study aimed at evaluating the exposure and clinical significance of drug–drug (DDIs) and drug–dietary supplement interactions (DDSIs) in patients admitted for CTS in the University Hospital of Crete Greece. DDIs were evaluated regarding underlying pharmacological mechanisms upon admission, preoperation, postoperation, and discharge from CTS clinic. Additionally, upon admission, the use of dietary supplements (DSs) and if patients had informed their treating physician that they were using these were recorded with subsequent analysis of potential DDSIs with prescribed medications. Results: The study employed 76 patients who were admitted for CTS and accepted to participate. Overall, 166 unique DDIs were identified, with 32% of them being related to pharmacokinetic (PK) processes and the rest (68%) were related to possible alterations of pharmacodynamic (PD) action. CVD medications and drugs for central nervous system disorders were the most frequently interacting medications. In total, 12% of the identified DDIs were of serious clinical significance. The frequency of PK-DDIs was higher during admission and discharge, whereas PD-DDIs were mainly recorded during pre- and postoperation periods. Regarding DS usage, 60% of patients were using DSs and perceived them as safe, and the majority had not informed their treating physician of this or sought out medical advice. Analysis of medical records showed 30 potential combinations with prescribed medications that could lead in DDSIs due to modulation of PK or PD processes, and grapefruit juice consumption was involved in 38% of them. Conclusions: An increased burden of DDIs and DDSIs was identified mostly upon admission for patients in CTS clinics in Greece. Healthcare providers, especially prescribing physicians in Greece, should always take into consideration the possibility of DDIs and the likely use of DS products by patients to promote their well-being; this should only be undertaken after receiving medical advice and an evidenced-based evaluation.
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Lee JW, Morris JK, Wald NJ. The Reply. Am J Med 2016; 129:e303. [PMID: 27770846 DOI: 10.1016/j.amjmed.2016.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Jonathan W Lee
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Joan K Morris
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Nicholas J Wald
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
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