Thousands of patients prescribed high-risk drugs
Thousands of patients in Scotland who are particularly vulnerable to adverse drug events (ADEs) were prescribed high-risk medications by their GPs which could potentially cause them harm, according to research published in the British Medical Journal today.
Although at least some of this prescribing will be appropriate because prescribers and patients are balancing risks and benefits when there may be no clearly 'correct' course of action, the study also finds that there was significant variation in the prescribing practices between the GPs surgeries surveyed. This variation could not be explained by the patient case mix which suggests that there is considerable scope to improve prescribing practices, say the researchers.
The authors, led by Professor Bruce Guthrie from Dundee University, say that previous studies have shown that GP prescribing can cause considerable harm, and they highlight that "adverse drug events (ADEs) account for 6.5% of all hospital admissions, over half of which are judged to be preventable".
Patients could be vulnerable to high risk drugs because of their age, other existing illnesses or because of other prescription medications they may be on. GPs need to be alert to these risk factors and be cautious about the drugs they prescribe to these patients, say the authors.
A number of medications or scenarios are already flagged up as high risk, for example, non-steroidal anti-inflammatory drugs for certain patients, prescribing a new drug when a patient is on the blood-thinning medication warfarin, prescribing drugs when patients have heart failure and prescribing antipsychotic drugs for patients who have dementia.
Guthrie and colleagues expanded the list above and developed 15 indicators to examine how often patients vulnerable to ADEs were prescribed high-risk medication that could harm them.
The authors used the indicators to review data from 315 Scottish General Practices with 1.76 million patients, of which 139,404 (7.9%) were identified as being particularly vulnerable to ADEs.
The results show that 19,308 (13.9%) who were in the vulnerable group were prescribed one or more high-risk medications.
While the authors emphasise that not all high-risk prescribing is inappropriate they conclude that the study shows "that opportunities to improve primary care prescribing safety are considerable" across the UK.
Provided by British Medical Journal
- Article outlines principles for a conservative approach to prescribing medication Jun 13, 2011 | not rated yet | 0
- One-in-six elderly dementia patients receiving anti-psychotic drugs Jul 23, 2010 | not rated yet | 0
- Electronic prescribing system may encourage physicians to choose lower-cost drugs Dec 08, 2008 | not rated yet | 0
- Study examines prescribing of antipsychotic medications for nursing home residents Jan 11, 2010 | not rated yet | 0
- Physicians click their way to better prescriptions Mar 10, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be villous adenoma in colon, if there are no villi there
11 hours ago As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
- More from Physics Forums - Medical Sciences
More news stories
(AP)—A federal panel of medical experts says that an experimental insomnia drug from Merck & Co Inc. appears safe and effective, despite evidence from company trials that the pill can cause daytime sleepiness and difficulty ...
Medications 45 minutes ago | not rated yet | 0
GlaxoSmithKline PLC says it's starting an unusual collaboration with the U.S. government to develop several antibiotics for both bioterrorism threats and bacterial infections resistant to current medicines.
Medications 2 hours ago | not rated yet | 0
The new 13-valent pneumococcal conjugate vaccine (PCV13) appears to be as safe as the previous version used prior to 2010, the 7-valent pneumococcal conjugate vaccine (PCV7), according to a Kaiser Permanente study published ...
Medications 7 hours ago | not rated yet | 0
The University of Gothenburg Vaccine Research Institute (GUVAX) announces successful results in a placebo controlled phase I study of an oral, inactivated Escherichia coli diarrhea vaccine.
Medications 10 hours ago | not rated yet | 0
(HealthDay)—For HIV-infected individuals with recurrent Clostridium difficile infection, fecal microbiota therapy is feasible, according to a letter published in the May 21 issue of the Annals of Intern ...
34 minutes ago | not rated yet | 0
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
2 hours ago | 5 / 5 (1) | 0 |
(HealthDay)—Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published ...
1 hour ago | not rated yet | 0
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
2 hours ago | not rated yet | 1 |
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
5 hours ago | 4.5 / 5 (2) | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
3 hours ago | not rated yet | 0 |