• Users Online: 249
  • Print this page
  • Email this page


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 5  |  Issue : 2  |  Page : 82-85

Public knowledge and awareness about food–drug interactions in the northern border region, Saudi Arabia


Department of Clinical Nutrition, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia

Date of Submission30-Nov-2020
Date of Decision13-Dec-2020
Date of Acceptance28-Dec-2020
Date of Web Publication25-Feb-2021

Correspondence Address:
Prof. Nasser Salem Alqahtani
Department of Clinical Nutrition, College of Applied Medical Sciences, Northern Border University, PO Box 1321, Arar
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/KKUJHS.KKUJHS_27_20

Rights and Permissions
  Abstract 

Background: Food–drug interactions (FDIs) are underreported which could be due to a variety of factors such as lack of food history, follow-ups, or unawareness. Objective: The present study intended to investigate the degree of existing knowledge and awareness of FDIs among the Saudi people. Methodology: This is a cross-sectional study conducted in the Northern Border Region, Arar city of Saudi, among a random convenient sample of 223 people. Voluntary participants filled a predesigned self-administered questionnaire comprising 22 close-ended questions and 1 open-ended question. Data were collected for a duration of 2 months and descriptive analysis was performed to obtain frequencies of responses. Results: The overall response rate was 89% with a larger number of females and 79% belonging to the 20–30 age group. Of the study population, only 6% reported having experienced such FDIs at least once in their lifetime. Almost 97% believe that they should read the label of any drug before consuming it. More than half of the participants (52%) agreed that acidic foods and beverages such as tomato sauce, tea, coffee, and citrus juices affect drug absorption and may cause food/drug interaction. About 62% believe that alcohol and drugs should never be clubbed. Conclusion: It is hereby shown that FDIs' awareness and knowledge were poor among the Saudi population. This, however, can be addressed as a high proportion of respondents had a positive attitude toward reading the drug label before use.

Keywords: Attitude, food–drug interactions, knowledge, Saudi people


How to cite this article:
Alqahtani NS. Public knowledge and awareness about food–drug interactions in the northern border region, Saudi Arabia. King Khalid Univ J Health Sci 2020;5:82-5

How to cite this URL:
Alqahtani NS. Public knowledge and awareness about food–drug interactions in the northern border region, Saudi Arabia. King Khalid Univ J Health Sci [serial online] 2020 [cited 2021 Apr 10];5:82-5. Available from: https://www.kkujhs.org/text.asp?2020/5/2/82/309607


  Introduction Top


The safe and adequate intake of medicines is necessary to ensure that the chemical substances in them deliver a predictable and desired effect in the human body. The ideology of medications involves that the drugs be highly specific, exhibit linear potency, be nontoxic, and most importantly, not be affected by concomitant foods or other medications.[1] By definition, a drug interaction is “a situation in which a substance affects the activity of a drug, i.e., the effects are increased or decreased, or they produce a new effect that neither produces on its own.[2]

Several studies report the incidence of drug interactions in the range of 3%–30%.[3],[4] Most medications have powerful ingredients that interact with the human body in different ways, depending on what they interact with. When the activity involves food substances, it results in what is known as food–drug interactions (FDIs). Such activity can lead to changes in drug metabolism. It can bring about alterations to reduce or accelerate the effect or can produce a new effect altogether. Some herbs, fruits, and alcohol use can even cause failure of therapy, causing deleterious effects on health.[5]

The physiological secretions following food intake in the gastrointestinal tract can impact the bioavailability of some drugs.[6],[7] Drug interaction is a widely unrecognized source of errors due to changes in pharmacodynamics and/or pharmacokinetics.[8] Food may either delay or decrease the absorption of drugs or reversely, food may increase tolerance of drugs when taken together. It is advised to consult the prescribing doctor, regarding timings of food consumption and medicine.[9]

FDIs can reduce the therapeutic effect of the drug, change the side effects from a medicine to get worse or better, or may cause a new side effect that is not predictable. Most people assume that naturally derived herbs and foods are potentially safe, but by altering kinetic and dynamics of drugs, they can cause adverse reactions or even oppose the effects.[10],[11]

The consumers of a drug may be able to recognize the inadvertent effects of the drug the patient consumes but may not be able to attribute this effect to an interaction caused by a food or herb that a person normally eats as a part of the diet.

FDIs are underreported which could be due to a variety of factors, such as lack of food history, follow–ups, or unawareness.[12] The complex nature of FDIs requires that it receives attention by not only health-care professionals but by the patients as well. It is thus crucial that the public have knowledge about food and drug interactions, and thus, there is a need to increase available information concerning these interactions to decrease the health consequences caused by them. An understanding of the existing knowledge can help to create awareness about such interactions and aid people to make appropriate food choices while consuming a certain drug(s). The present study intended to investigate the degree of existing knowledge and awareness on FDIs among people of Saudi.


  Methodology Top


Study design

The study was cross sectional conducted in Arar city – Northern Border Region of Saudi Arabia during the period of February to March 2018.

The questionnaire was predesigned comprising 22 close-ended questions and 1 open-ended question, pertaining to some of the common FDI mentioned in literature. The questionnaire was self-validated by an internal team of experts. A pilot study was conducted on a small group of random people to assess the clarity and time taken to fill the questionnaire.

Conducting the survey

The study employed a convenient, random sample of 223 Saudi people (aged 21–60 years) from secondary school and shopping malls of the region. Informed consent was obtained from all participants before filling out the FDI questionnaire. Each participant took about 15–20 min to complete the questionnaire.

The participation was voluntary and data obtained were kept confidential. Responses were quantified numerically by assigning numbers to each response of corresponding questions. The study protocol was approved by the Institutional Ethics Committee.

Using MS Excel, the data were stored and descriptive statistics was carried out to obtain frequencies and percentages.


  Results Top


The survey was completed within 2 months' duration. An overall response rate of 89% was observed, yielding a total sample of 223 Saudi people. Majority of respondents (85%) were female and 15% were male. A larger percentage (79%) was highly educated and 62% of participants belonged to the age group of 20–30 years [Table 1]. As for knowledge, 88% of them knew that food and beverage can interfere with drugs taken and that food can speed up or slow down the action of a drug. About 58% knew that fruit juice, alcohol, vitamins, and iron and 52% knew that acidic foods and beverages (tomato sauce, tea, coffee, and citrus juices) effect on drug absorption and may involve food/drug interaction. It is believed by almost two-third population that drugs should be taken after meal intake. About 62% believe that alcohol and drugs should never be clubbed. Regarding specific drug reactions, only 24% are aware that milk is to be avoided with tetracyclines and 34% know that vitamins are to be consumed at the same time as food. Half the study population scored “good” knowledge about FDIs. Of the study population, only 6% reported having experienced such FDIs at least once in their lifetime. Almost 97% believe that they should read the label of any drug before consuming. [Table 2] summarizes the score obtained through the means of the study.
Table 1: Demographic details of the study participants

Click here to view
Table 2: Response of participants for the knowledge, experience, and attitude

Click here to view



  Discussion Top


Drug interactions are consequences in which the effects of one drug are altered by prior or concurrent administration of another drug. Specific foods greatly affect drug therapy, resulting in serious side effects, or reduced absorption of a drug, i.e., therapeutic failure or increase bioavailability.[13] The prevalence of FDIs found in our study was only 6%.

The current study was conducted to determine the degree of knowledge and awareness on FDIs among people Saudi. The results of the present study indicated that the average score of knowledge about FDIs among the Saudi general population was poor (50.6%) which is consistent with Hassali et al., Indermitte et al., and Kaufman et al., indicating poor knowledge about drug interactions with certain foods or traditional medicines.[14],[15],[16] The Malaysian population however shows a good knowledge as reported among 70% by Omar et al.

It is usually instructed by physicians not to use alcohol while taking medications, especially metronidazole, first-generation antihistamines. Not complying to do so can lead to effects and tachycardia, nausea, vomiting, and increased drowsiness are some of them.[17],[18] Similar precautions for other drugs include, that PPIs and Izoniazid be taken empty stomach for accurate benefit as food interferes with their bioavailability.[19],[20] It was however revealed by the study that 73% of participants believe that drugs should always be taken after meals only.

Bailey et al. in 1998 found that grapefruit can augment the oral bioavailability and increase adverse effects of a broad range of medicines; however, only 21% of the study participants had a fair knowledge about the same.[21] The fact that milk should be avoided with tetracycline as it chelates with the same was known only by 24% of participants of the present study.[22]

Such limited information leads to improper use of medicines and information pertaining to these should be provided by the physicians and pharmacists. All these current data, along with that reported by Budnitz and Layde 2007, suggest that it is hard for patients to retain all such information pertaining to varied drugs, and thus, it is essential that consumers of medicines read the labels and instructions properly themselves. Majority of participants (97%) in this study had a good attitude and believed that patients should read the label before using the drug.[23] Moreover, higher than three-quarter of participants would like to receive more information about FDIs which indicates their good attitude and acceptance for further education about FDIs.

A similar finding was found by Alrabiah et al. and Al-Arifi et al., poor knowledge regarding FDIs has been found among the people of Saudi Arabia.[24],[25]

Addressing the limitations of the current study, it is suggested that further long-term studies with a larger and more generalizable population be conducted, as this was only a cross-sectional study giving a snapshot of the FDIs among a small Saudi population.


  Conclusion Top


It is hereby shown that FDIs' awareness and knowledge were poor among the Saudi population. This however can be addressed as a high proportion of respondents had a positive attitude toward reading the drug label before use. The findings of this study on food and drug interactions awareness and knowledge bring to light the need to intensify efforts to create awareness to reduce the incidence of FDIs. Health education programs are required to improve the knowledge of the public toward FDIs.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
McCabe-Sellers B, Frankel EH, Wolfe JJ. Handbook of Food-drug Interactions. United States: CRC Press; 2003.  Back to cited text no. 1
    
2.
Wolffgramm J, Heyne A. From controlled drug intake to loss of control: The irreversible development of drug addiction in the rat. Behav Brain Res 1995;70:94-77.  Back to cited text no. 2
    
3.
Gosney M, Tallis R. Prescription of contraindicated and interacting drugs in elderly patients admitted to hospital. Lancet 1984;2:564-7.  Back to cited text no. 3
    
4.
Kinney EL. Expert system detection of drug interactions: Results in consecutive inpatients. Comput Biomed Res 1986;19:462-6.  Back to cited text no. 4
    
5.
Bushra R, Aslam N, Khan AY. Food-drug interactions. Oman Med J 2011;26:77-9.  Back to cited text no. 5
    
6.
Schmidt LE, Dalhoff K. Food-drug interactions. Drugs 2002;62:1481-5.  Back to cited text no. 6
    
7.
Nekvindova J, Anzenbacher P. Interactions of food and dietary supplements with drug metabolising cytochrome P450 enzymes. Ceska Slov Farm 2007;56:165-7.  Back to cited text no. 7
    
8.
Abarca J, Malone DC, Armstrong EP, Grizzle AJ, Hansten PD, Van Bergen RC, et al. Concordance of severity ratings provided in four drug interaction compendia. J Am Pharm Assoc 2004;44:136-41.  Back to cited text no. 8
    
9.
Williams L, Hill DP Jr., Davis JA, Lowenthal DT. The influence of food on the absorption and metabolism of drugs: An update. Eur J Drug Metab Pharmacokinet 1996;21:201-11.  Back to cited text no. 9
    
10.
Fugh-Berman A. Herb-drug interactions. Lancet 2000;355:134-8.  Back to cited text no. 10
    
11.
Huang SM, Hall SD, Watkins P, Love LA, Serabjit-Singh C, Betz JM, et al. Drug interactions with herbal products and grapefruit juice: A conference report. Clin Pharmacol Ther 2004;75:1-12.  Back to cited text no. 11
    
12.
Benni JM, Jayanthi MK, Basavaraj R, Renuka MJ. Knowledge and awareness of food and drug interactions (FDI): A survey among health care professionals. Int J Pharmacol Clin Sci 2012;1:97-105.  Back to cited text no. 12
    
13.
Aman SF, Hassan F, Naqvi BS, Hasan SM. Studies of food drug interactions. Pak J Pharm Sci 2010;23:313-20.  Back to cited text no. 13
    
14.
Hassali M, Khan T, Shafie A. Use of drug information resources by the community pharmacist in Penang, Malaysia. Inform Prim Care 2010;18:213-6.  Back to cited text no. 14
    
15.
Indermitte J, Reber D, Beutler M, Bruppacher R, Hersberger KE. Prevalence and patient awareness of selected potential drug interactions with self-medication. J Clin Pharm Ther 2007;32:149-59.  Back to cited text no. 15
    
16.
Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: The Slone survey. JAMA 2002;287:337-44.  Back to cited text no. 16
    
17.
Dawood OT, Hassali MA, Saleem F. Factors affecting knowledge and practice of medicine use among the general public in the state of Penang, Malaysia. J Pharm Health Serv Res 2017;8:51-75.  Back to cited text no. 17
    
18.
Harries DP, Teale KF, Sunderland G. Metronidazole and alcohol: Potential problems. Scott Med J 1990;35:179-80.  Back to cited text no. 18
    
19.
Self TH, Chrisman CR, Baciewicz AM, Bronze MS. Isoniazid drug and food interactions. Am J Med Sci 1999;317:304-20.  Back to cited text no. 19
    
20.
Sharma P, Singh S, Siddiqui TI, Singh VS, Kundu B, Prathipati P, et al. Alpha-amino acid derivatives as proton pump inhibitors and potent anti-ulcer agents. Eur J Med Chem 2007;42:386-93.  Back to cited text no. 20
    
21.
Bailey DG, Malcolm J, Arnold O, Spence JD. Grapefruit juice-drug interactions. 1998. Br J Clin Pharmacol 2004;58:S831-40.  Back to cited text no. 21
    
22.
Gurley BJ, Hagan DW. Herbal and dietary supplement interactions with drugs. In: McCabe BJ, Frankel EH, Wolfe JJ, editors. Hand Book of Food-drug Interactions. Vol. 29. Boca Raton: CRC Press; 2003. p. 259-93.  Back to cited text no. 22
    
23.
Budnitz DS, Layde PM. Outpatient drug safety: New steps in an old direction. Pharmacoepidemiol Drug Saf 2007;16:160-5.  Back to cited text no. 23
    
24.
Alrabiah Z, Alhossan A, Alghadeer SM, Wajid S, Babelghaith SD, Al-Arifi MN. Evaluation of community pharmacists' knowledge about drug-drug interaction in Central Saudi Arabia. Saudi Pharm J 2019;27:463-6.  Back to cited text no. 24
    
25.
Al-Arifi MN, Wajid S, Al-Manie NK, Al-Saker FM, Babelgaith SD, Asiri YA, et al. Evaluation of knowledge of Health care professionals on warfarin interactions with drug and herb medicinal in Central Saudi Arabia. Pak J Med Sci 2016;32:229.  Back to cited text no. 25
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Methodology
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed140    
    Printed0    
    Emailed0    
    PDF Downloaded18    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]