Food-Drug Interactions: Implications for Nursing Practice

Background: Registered nurses (RNs) play important roles in patient safety.Medication errors resulting in adverse drug reactions (ADRs) pose a significant public health problem. A safety concern, which can lead to treatment failure, is concurrently administering drugs and foods which interact negatively. For example, administering warfarin and foods rich in vitamin K together result in pharmacodynamic antagonism of the warfarin. Studies on the knowledge, attitudes and awareness of food and drug interactions (FDIs) among nurses with different educational levels are lacking. The purpose of this study wasto ascertain the knowledge, awareness and attitudes of RNs regarding FDIs, and to investigate the relationship between their educational levels and their scores on the Nurses' Knowledge, Awareness and Attitudes Survey. Methods: This was a cross-sectional descriptive study which included a structured questionnaire with emphasis on common FDIs found in medical journals. The study protocol was approved by the Howard University Institutional Review Board. The FDI questionnaire consists of 40 questions (including dichotomous, multiple choice and open-ended questions). The study included a convenience sample of 278 nurses divided into 3 groups (82 with associate degrees, 151 with baccalaureate degrees, and 45 with graduate degrees). Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS), version 22 (IBM SPSS Inc., Chicago, Illinois). The Neuman Systems Model provided the theoretical framework for the study. Results: Twenty-two percent (22%) of the participants were male, and seventy-eight percent (78%) were female. There was no statistically significant relationship between knowledge and practice of FDI among the 3 groups. Of the 72% of nurses who had not observed food and drug interaction during their practice, 80.5% were associate degree holders, 73.5% had baccalaureate degrees, and 53% had earned graduate degrees. There were no significant differences in FDI knowledge scores among the associate degree, baccalaureate degree and graduate degree prepared nurses. The level of awareness of adverse effects resulting from FDIs was directly related to the level of nurses' education. About 28% of the study participants had recorded FDIs during their clinical practice. Nurses prepared at the graduate degree level, had witnessed more FDIs than the associate and baccalaureate degree holders. Conclusions: The results of this study showed that nursing health care professionals exhibit a low knowledge of FDI. The low scores observed, suggest that knowledge and attitude deficits continue to exist. Education exposes a nurse to different possible FDIs. Most of the participants recommended in-house training on FDI every six (6) months. The authors are aware that demographic characteristics such as the unit in which the nurses practice, full time or part-time and the type of organizationmay influence a nurse's knowledge, practice and awareness of FDIs. It is recommended that future studies on this subject include larger sample sizes