International Journal of Clinical Pharmacy (2018) 40:668–675
Evaluation of community pharmacists’ knowledge and awareness
of food–drug interactions in Palestine
· Anwar Sweileh
· We’am Shraim
· Amr Hroub
· Josephean Elaraj
· Naser Shraim
Received: 25 May 2017 / Accepted: 19 April 2018 / Published online: 2 May 2018
© Springer International Publishing AG, part of Springer Nature 2018
Background Food–drug interactions can produce undesirable outcomes during the therapy process. The pharmacist is respon-
sible for providing patients counseling about common food-drug interactions. Knowledge of such interactions is important
to avoid their occurrence. Objective This study aimed to assess the knowledge and awareness of community pharmacists
about common food-drug interactions. Setting Pharmacists working in community pharmacies across Northern Palestine.
Method This is a cross-sectional study, which involved a convenience sample of 259 pharmacists working in community
pharmacies in Palestine. A self-administered questionnaire consisted of 29 questions (mainly yes/no questions) was used to
assess pharmacists’ knowledge towards the most common and clinically signiﬁcant interactions between food and medicines.
Main outcome measure Pharmacists’ issues related to the knowledge of food drug interactions were evaluated. Results A
total of 320 questionnaires were distributed of which 259 were completed providing a response rate 80.9%. One pharmacist
from each community pharmacy was asked to complete the questionnaire. The overall knowledge score of food-drug interac-
tions for the pharmacists was 17.9 (61.7%) out of a possible maximum of 29. The pharmacists surveyed in this study have
demonstrated good knowledge of some interactions; but poor knowledge of others. Conclusion Pharmacists’ knowledge
about common food–drug interactions is inadequate. These ﬁndings support the need for training and educational courses
for pharmacists regarding food–drug interactions.
Keywords Community pharmacists · Drug interactions · Food–drug interactions · Knowledge · Palestine
Impacts on practice
Pharmacists are responsible for providing counseling to
patients about clinically signiﬁcant food–drug interac-
tions and inadequate knowledge may result in adverse
Eﬀorts should be made to provide training and continu-
ous education for community pharmacists’ to raise their
awareness about potential food–drug interactions
Food may have positive or negative eﬀects on the drug bio-
availability, which may lead to therapeutic failure or drug
toxicity. Food–drug interactions (FDIs) are of important
concern in the medical practice; they may adversely aﬀect
the drug’s eﬀectiveness and prolong the patient’s hospitali-
zation and be life threatening . The prevalence of poten-
tial FDIs in diﬀerent countries varies in the range from 6
to 70% [2–4]. However, the incidence of clinically relevant
FDIs in the population of patients in Palestine has not been
assessed so far.
Food can alter drug’s bioavailability by introducing
changes in the GI physiology such as; gastric emptying,
gastric pH, GI motility, the activity of the metabolizing
enzymes and the transport proteins such as P-glycoprotein.
Furthermore, food components may bind or chelate to the
active pharmaceutical ingredient .
Several studies have reported the evidence of inter-
actions between certain types of food and medications.
* Asma Radwan
Department of Pharmacy, An-Najah National University,
P.O. Box 7, Nablus, Palestine