ArticleFrontiers in medicine2026
Evaluation of community pharmacists' knowledge and real-world practices in drug interaction management: a cross-sectional study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Drug-drug interactions (DDIs) remain a significant but often overlooked threat to patient safety. While Pharmacists are expected to play a critical role in identifying and preventing DDIs, real-world practice may not reflect this responsibility. This study aimed to assess the gap between community Pharmacists' DDI knowledge and their actual dispensing practices in Western Saudi Arabia. Methods: A sequential explanatory mixed-methods study was conducted between September and November 2025 among 356 licensed community Pharmacists in Makkah, Jeddah, Madinah, and Taif. The quantitative phase involved a validated, structured questionnaire evaluating Pharmacists' knowledge and self-reported practices regarding DDIs. This was followed by a qualitative observational phase involving 134 unannounced simulated patient (SP) visits, each presenting one of four predefined high-risk DDI scenarios (ibuprofen-furosemide, omeprazole-clopidogrel, fluconazole-phenytoin, and phenytoin-warfarin). Statistical analyses included descriptive statistics, non-parametric group comparisons (Wilcoxon and Kruskal-Wallis tests), multivariable linear regression, and Fisher's exact test, conducted using RStudio ( Results: Survey findings demonstrated moderate to high theoretical DDI awareness, with 62-79% of Pharmacists correctly identifying major interaction pairs. Pharm. D. graduates achieved higher knowledge scores than B. Pharm graduates (median 5.0 vs. 4.0; Conclusion: Despite adequate theoretical knowledge, community Pharmacists demonstrated limited real-world application of DDI management. This knowledge-practice gap poses a patient safety concern and underscores the need for system-level interventions, including decision-support tools, workflow optimization, and strengthened prescriber-Pharmacist communication.
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