Assessing Physicians' Knowledge Concerning Food-Drug Interactions in Sana'a City, Yemen

Abstract

Background: Certain foods and specific nutrients can interact with some drugs, potentially affecting their therapeutic efficacy and safety. A thorough understanding of food-drug interactions (FDIs) across various medical specialties is crucial in preventing these interactions in patients. Physicians have a key role in preventing these issues, as they are responsible for prescribing drugs and advising patients on dietary management. This study, therefore, aimed to investigate the knowledge of common FDIs and appropriate timing for drug administration among physicians in Sana’a City, Yemen.

Methods: A cross-sectional study was conducted from May to June 2021 among 499 physicians working in four public and two private hospitals in Sana’a City, Yemen. Data about physicians’ FDIs and the timing of drug administration in relation to food intake were collected using a self-administered questionnaire. The Mann-Whitney U and Kruskal-Wallis H tests were used to determine the factors influencing physicians’ knowledge of FDIs and appropriate timing of drug administration.

Results: Of the 499 physicians surveyed, 26.3% perceived that they had sufficient knowledge of FDIs. Most physicians correctly identified the interaction between caffeine and diazepam (79.6%) and the need to avoid potassium-rich foods with spironolactone (64.9%), followed by those who recognized interactions involving theophylline (59.3%) and tetracycline with milk (51.9%). Fewer physicians were aware of interactions such as grapefruit with amiodarone (30.3%) and atorvastatin (28.7%), wheat bran with digoxin (24.2%), and aged cheeses with monoamine oxidase inhibitors (27.7%). Most respondents correctly identified the appropriate timing for administering omeprazole (79.8%) and erythromycin (71.7%), followed by metformin (58.7%) and methotrexate (46.0%). Fewer answered correctly for propranolol (37.7%), levothyroxine (32.5%), calcium carbonate supplements (32.5%), isotretinoin (26.5%), glipizide (23.2%), griseofulvin (20.3%), and carbamazepine (12.8%). Physicians’ knowledge of FDIs was significantly higher among physicians aged over 40 (P = 0.046) and consultants compared to their counterparts. Conversely, there were no statistically significant differences in physicians’ knowledge of FDIs with respect to their gender, type of health facility, years of experience, or perceived knowledge of FDIs. On the other hand, physicians’ knowledge of appropriate drug administration timing was significantly higher among older physicians, males, consultants, those working in private clinics, and those having 5–10 years of experience compared to their counterparts.

Conclusion: Physicians in Sana’a show insufficient knowledge of common FDIs, highlighting the need for targeted educational initiatives. Training should focus on interaction mechanisms, common examples, and prevention strategies, using case studies to promote practical application in clinical practice.