Management of potential drug-drug interactions in prescriptions received in community pharmacies (Cameroon)

Abstract

Background: Pharmacists and community pharmacy staff are responsible for analysing prescriptions to identify possible drug-drug interactions (DDIs). This study aimed to describe the management of potential DDIs in prescriptions received in pharmacies. Material and Methods: A cross-sectional study with prospective data collection was conducted from November 2022 to May 2023 in all pharmacies of the Efoulan Health District. All legible prescriptions containing at least two drugs were included. Data were collected using a pre-tested form. Interactions were identified using the THERIAQUE® drug database, and data were analysed with IBM SPSS® Statistics version 23.0. Results: The study included 67 prescriptions containing 124 DDIs, averaging 1.8 interactions per prescription; 33.9% of prescriptions had only one DDI. Interactions were mainly pharmacodynamic (74.2%) and pharmacokinetic (25.8%), and were mostly classified as requiring consideration (52.5%). The most frequently detected interactions were pharmacokinetic ones (13.7%) and combinations requiring caution (13.7%). Pharmacodynamic interactions mainly resulted from synergism (89.1%), and pharmacokinetic interactions from complexation (59.4%). Prescribers were mainly cardiologists (42.9%) and general practitioners (42.9%), and interactions occurred mostly between two non-steroidal anti-inflammatory drugs. The overall detection rate was low (21.8%), relying mainly on personal knowledge (85.2%) rather than physical documents (14.8%). Actions taken included advising the patient (55.5%), taking no action (40.8%), and referring the patient back to the prescriber (3.7%). Conclusion: Many drug interactions can occur following medical prescriptions, but few are detected by dispensers, and the resulting attitudes vary.