Government review finds 10% of drugs dispensed in England unnecessary

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Ministers ordered a crackdown on overprescribing drugs after a review found that one in 10 drugs dispensed by general practitioners and pharmacists is unnecessary and potentially dangerous.

Family physicians will be asked to increase the use of social prescribing, such as gardening, walking or volunteering. They are also urged to call millions of patients for drug reviews to see if there are any pills they can stop taking.

The landmark review, ordered by the government in 2018 and released on Wednesday, concludes that overprescribing is a “serious problem.” Up to 110 million drugs given to patients each year can be unnecessary and even potentially dangerous, he suggests.

More than one in six people (15%) in England now take five or more medications per day, which increases the risk of side effects, according to the journal. One in 14 (7%) takes eight or more drugs.

About one in five hospitalizations among those over 65 and 6.5% of all hospitalizations are due to adverse drug reactions. The more pills a person takes, the greater the chance that one or more of these medicines will have an unwanted or harmful effect. Some medicines, such as those used to lower blood pressure, can also increase the risk of falls in frail and elderly people.

The findings follow a report from Public Health England in 2019 which found that a quarter of adults in England were taking potentially addicting prescription drugs, with up to half of them dependent on long-term drugs.

Led by NHS England Pharmaceutical Director Dr Keith Ridge, the new review found that 10% of prescription items dispensed through primary care in England are inappropriate for that patient’s circumstances or wishes, or could be replaced by better alternative treatments.

Total estimated NHS spending on drugs in England fell from £ 13bn in 2010/11 to £ 18.2bn in 2017/18. This represents an average growth of 5% per year – with 1.1 billion prescription items dispensed in primary care by general practitioners and pharmacists each year.

Overprescribing, when patients are given drugs they don’t need or want, or when the potential harm outweighs the drug’s benefits, has been of growing concern to health officials these days. last years. This can happen when a better alternative is available but not prescribed, the drug is appropriate for a condition but not for the particular patient, a condition changes and the drug is no longer appropriate, or the patient is no longer suitable. no longer needs the drug but continues to be prescribed this.

Sajid Javid, the Secretary of Health, welcomed the report. “This is an extremely important review that will have a lasting impact on people’s lives and improve the way drugs are prescribed,” he said.

“With 15% of people taking five or more drugs a day, in some cases to deal with side effects of another drug, more needs to be done to listen to patients and help clinical teams fight overprescribing. “

The authors said that while they did not want to set a target for reducing overprescribing, a 10% reduction is “realistic.” The journal adds, “This would equate to a reduction of approximately 110 million articles per year. “

Javid accepted all of the review’s recommendations and pledged to take action to prevent unnecessary medication being prescribed. Reforms in the training of pharmacists are already underway, he said. The government will also appoint a national clinical director for prescribing.

The review also recommends ‘system-wide changes’ to improve patient records and transfers between GPs and hospitals, as well as a national toolkit and training to support primary care staff. to improve the consistency of repeated prescriptions. Repeat prescriptions make up about three-quarters of all prescription items, according to the report, and can be left unchecked for long periods of time, increasing the risk of overprescribing.

There must be support for patients who have withdrawn from drugs but are struggling to give up on them, according to the review. General practitioners should also be empowered to challenge and change prescribing decisions made in hospitals, he adds.

Ridge said that while overprescribing was a ‘global problem’, it was essential for the NHS to step up the efforts it has already made to tackle the problem.

“Drugs do people a lot of good, and the practical steps outlined in this report will help clinicians ensure that people get the right kind and amount of drugs, which is better for patients and also benefits taxpayers, by avoiding unnecessary spending on prescriptions, ”he said.

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