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Non-steroidal Anti-inflammatory Drug Misuse: Knowledge, Attitudes and Practices of Community Pharmacists in Morocco
Nada Benzine1,2, Hanan Rkain3, Fatine Kronbi1,2
1Department of Rheumatology B, Ayachi Hospital, Ibn Sina Hospital Center, Rabat, MAR.
Abstract:
Objective This study aimed to assess the level of knowledge, attitudes, and practices of community pharmacists in Morocco regarding the misuse of non-steroidal anti-inflammatory drugs (NSAIDs) and to identify factors influencing their management of such cases in daily practice. Methods A descriptive cross-sectional study was conducted among community pharmacists in Morocco using a structured, self-administered questionnaire distributed via Google Forms between February 10 and April 30, 2024. The questionnaire collected information on pharmacists' sociodemographic characteristics, knowledge, attitudes, and practices regarding the misuse of NSAIDs. Knowledge and attitudes were assessed using a five-point Likert scale. The questionnaire was pre-tested for clarity and internal consistency. Data were analyzed using descriptive statistics and inferential tests (e.g., Chi-square) where applicable. Ethical approval was obtained from the Ethics Committee of Mohammed V University in Rabat, and participation was voluntary with informed consent. Results A total of 100 pharmacists participated in the survey. The mean age was 44 years, 55.3% were women, and the mean professional experience was 17 years. Approximately 60% demonstrated a clear understanding of NSAID misuse. Most were aware that NSAIDs can cause gastric ulcers (96%) and should be used with caution in individuals with cardiovascular conditions (83%). The main reasons cited for misuse were persistent or severe pain (82%) and lack of awareness of side effects (79%). Financial constraints were reported by 55% as a barrier to preventing misuse. In daily practice, 84% of pharmacists always informed patients of the maximum safe dose, 85% explained the recommended treatment duration, and 70% checked for health conditions that could make NSAID use unsafe before dispensing. Conclusion This study provides important insights into NSAID misuse in community pharmacies in Morocco and the challenges faced in addressing it. The findings indicate that patient education is a crucial factor in limiting misuse, and a multidisciplinary approach involving different healthcare professionals is necessary to effectively tackle this public health concern. Comparable studies in North African and Middle Eastern countries have reported similar challenges, highlighting insufficient patient education and limited pharmacist intervention as key contributors to NSAID misuse.
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