Assessment of community pharmacists' knowledge on rivaroxaban drug and food interactions in Sudan

This study aimed to assess community pharmacists knowledge of Rivaroxaban drug and food interactions in Sudan addressing gaps in understanding crucial for patient safety. The use of rivaroxaban is increasing globally, ensuring pharmacists are equipped to manage its administration and interactions are vital, particularly in settings with limited prior exposure to direct oral anticoagulants (DOACs). This is the first study to assess DOAC knowledge among community pharmacists in Sudan, a low-resource context with unique pharmacy practice challenges. A survey with 15 questions was conducted among 420 community pharmacists in Sudan. The questionnaire evaluated knowledge of administration requirements, herbal and drug interactions, dispensing practices, patient education strategies, and self-reported confidence levels. Key measures included correct identification of dosage-specific administration guidelines, awareness of herbal and drug interactions, patient education practices, and confidence levels in handling Rivaroxaban. Pharmacists demonstrated strong knowledge of administration for higher doses (95.2% for food requirements of 15 mg/20 mg), but confusion persisted regarding lower doses (58.5% correct for 10 mg). Awareness of herbal interactions was high (91.2%), yet 45.6% never checked drug-drug interactions and 28.9% rarely did so (74.5% never or rarely). Patient education practices were inconsistent, with only 20.9% providing written materials and 10.7% offering no counseling. Confidence levels were moderate (56.3%), highlighting gaps between knowledge and practical application. Multivariate analysis identified prior DOAC training (AOR = 3.40; 95% CI 2.10-5.52; p < 0.001), more than 10 years of experience (AOR = 2.15; 95% CI 1.42-3.25; p < 0.001), and postgraduate education (AOR = 1.85; 95% CI 1.10-3.12; p = 0.018) as significant predictors of adequate knowledge. While pharmacists exhibited solid knowledge of some aspects, significant gaps remain in dosage-specific guidelines, drug interaction monitoring, and patient education. These shortcomings pose risks to patient safety and underscore the need for targeted training programs to enhance practical application skills.