Prevalence of Drug–Drug Interactions in Primary Care Prescriptions in Egypt: A Cross-Sectional Retrospective Study

Abstract

In clinical practice, drug–drug interactions (DDIs) pose significant risks to a large number of patients. Consequently, healthcare providers are required to diligently identify, monitor, and effectively handle these interactions in order to enhance patient outcomes. In Egypt, DDIs are poorly addressed, with no reports for DDIs in primary care. In our cross-sectional, retrospective, observational study, we collected a total of five thousand, eight hundred and twenty prescriptions across eight major governorates in Egypt. Prescriptions were collected over a span of 15 months between 1 June 2021 and 30 September 2022. These prescriptions were analyzed for potential DDIs using the Lexicomp® drug interactions tool. The prevalence of DDIs was found to be 18%, with 22% of the prescriptions having two or more potential DDIs. Moreover, we found 1447 DDIs of categories C (monitoring therapy recommended), D (therapy modification suggested), and X (avoid combination). The most commonly interacting drugs in our study were diclofenac, aspirin, and clopidogrel, while non-steroidal anti-inflammatory drugs (NSAIDs) were the most reported therapeutic class implicated in pharmacologic DDIs. Pharmacodynamic agonistic activity was the most common mechanism of interaction. Therefore, it is crucial to conduct screenings, detect early signs, and closely monitor drug–drug interactions (DDIs) to enhance patients’ overall health outcomes, medication responses, and safety. In this regard, the clinical pharmacist assumes a vital role in implementing these preventive measures.

Drug use survey to identify significant drug–drug interactions and assess clinical importance in the outpatient setting of a tertiary care hospital

“…[ 13 ] Few other studies conducted in Egypt (18%) and Iran (20.3%) provided significantly lower results. [ 14 15 ] Such wide difference in prevalence in different studies regarding potential DDI may be due to multiple factors, like the difference in the availability of alternative drugs, differing levels of prescriber experience, absence of clinical pharmacist service, and use of technological aids such as automated interaction alerts. The involvement of pharmacists and drug information software in reviewing hospitalized patients’ medication prescriptions can significantly decrease the prevalence and adverse effects of DDI.…”