Drug-drug interactions in repeat prescriptions at village dispensaries (bereg) in Malta

Abstract

Inappropriate treatments and drug-drug interactions (DDIs) are known to occur in settings where repeat prescriptions are issued. In view of this, a study was carried out to document any such problematic drug prescribing and propose changes that would enhance patient safety. A random sample of 100 clients who requested a repeat prescription at a group of peripheral village dispensaries (bere©) in southern Malta was chosen and following anonymisation, the drugs requested for such prescriptions were entered into a database. A freely available online DDI checker was used in the analysis of the results and these were rechecked through the appropriate section of the British National Formulary. The resulting DDIs were then grouped according to type, potential effect or disease for which the drugs were used. A total of 255 DDIs were detected in the prescriptions of 53 clients. Drug combinations with a potential for increased hypotensive effect were the most common cause of DDIs (49.8%) in this sample, but other categories of DDIs were found. These included DDIs which could affect the management of diabetic patients (27.3%), patients on psychiatric treatment (7%) and anticoagulants (4.8%) as well as DDIs that affected serum potassium levels (2.2%). The results obtained indicate that DDIs are common at a number of peripheral village dispensaries in Malta, and these could affect disease management in some patients. Other DDIs can be potentially harmful. Awareness, knowledge and vigilance by the prescribers involved remains crucial to address the issues raised by DDIs. Suggestions for addressing these issues on an administrative level are proposed.