Drug–Drug Interaction Management Among Pharmacists in Jordan: A National Comparative Survey

Abstract

Introduction: Drug–drug interactions (DDI) are a major, preventable cause of patient harm, a challenge amplified in Jordan by rising polypharmacy and documented high rates of medication errors. To date, no study in Jordan has systematically compared hospital and community pharmacists. This study aimed to conduct the first national, comparative assessment of DDI management among these two cadres. Materials and Methods: A national, cross-sectional study was conducted with 380 licensed pharmacists (175 hospitals, 205 community) recruited via proportionate stratified random sampling. A validated online questionnaire assessed demographics, objective DDI knowledge, professional attitudes, practices, and barriers. Multivariable logistic regression was used to identify independent predictors of high knowledge and optimal practice. All collected data were coded, cleaned, and analyzed using the Statistical Package for the Social Sciences (SPSS V28.0). Results: Hospital pharmacists achieved significantly higher mean objective knowledge scores than community pharmacists (10.3 vs. 8.1 out of 15, p < 0.001), a gap particularly wide for interactions involving high-risk OTC medications. The primary barrier for community pharmacists was a lack of access to patient data (85.4%), contrasting with high workload and physician resistance in hospitals. Optimal practice was independently predicted by higher knowledge (AOR = 1.25), a hospital practice setting (AOR = 3.65), and was inhibited by perceived physician resistance (AOR = 0.45). Conclusions: Jordanian hospital and community pharmacists operate in distinct worlds of knowledge and practice. A tailored, dual-pronged national strategy is essential. For hospitals, interventions should target interprofessional dynamics. For community pharmacies, health policy reform to provide access to integrated patient data is the most urgent priority. These findings highlight a globally relevant challenge of practice-setting disparities, offering a model for other nations to develop tailored, context-specific interventions to improve medication safety.