Unnecessary drugs: deprescribing is a way forward


Melbourne: Millions of drugs given to patients each year can be unnecessary and even potentially dangerous. Deprescribing is one way to go.

Millions of drugs given to patients each year can be unnecessary and even potentially dangerous, and this is a problem that occurs in both developed and developing economies.

The term polypharmacy originally meant the prescription of five or more drugs, but has come to also refer to the prescription of drugs with no current specific indication, which duplicate other drugs, or which are known to be ineffective for the condition being treated.

The problem is very common, especially among the elderly.

A recent survey published by Keith Ridge, pharmaceutical director for England, concludes that up to 110 million drugs given to patients each year can be unnecessary and even potentially dangerous.

In England, 15 percent of people now take five or more drugs per day, while 7 percent take eight or more drugs. A 2018 report from the University of Sydney recommended a strategy to reduce inappropriate polypharmacy.

Its recommendations included establishing incentives for healthcare professionals to encourage quality use of medicines by elderly patients.

But the problem is also a major public health issue in India.

Factors contributing to drug abuse in this region include health system and regulatory failures, poor prescribing practices by physicians, easy access to drugs from pharmacists without a prescription as well as lack of educating patients about their medications.

Increasingly, healthcare providers around the world are seeing deprescribing as a solution. This process, led by pharmacists and physicians, involves systematically stopping inappropriate, duplicative, or unnecessary medications.

Other solutions include so-called social prescribing, which takes into account a range of social, economic and environmental factors such as housing, economic resources, pollution, health behaviors and diet when prescribing.

In the UK, studies suggest it can improve people’s health and well-being and reduce the workload of healthcare professionals and the demand for secondary care services. In England, social prescribing is part of the NHS long term plan.

REALITY CHECK It is estimated that 36.1 percent of older Australians were affected by continuous polypharmacy.

In India, it has been estimated that at least 50 percent of the average family spending on drugs in the country is on irrational or unnecessary drugs and diagnostic tests.

In the United States, nearly half of people taking psychotropic medications, which include antipsychotic drugs used to treat schizophrenia, had no mental health diagnosis.

BIG IDEAS Quotes attributable to Dr. Justin Turner, Co-Director of the Canadian Deprescribing Network, Faculty of Pharmacy, University of Montreal.

We see a lot of patients struggling to take all the pills that are prescribed for them. They even end up taking drugs to treat the side effects of their drugs – this is called a cascade of prescriptions. Drug abuse is a silent pandemic.

Just because a drug was good for you when it started 10 years ago doesn’t mean it’s still good for you now.


(Featured articles available for republishing under CC 4.0)

Misuse of medicine: the silent pandemic By Justin Turner, University of Montreal

While modern drugs can save lives, if used for too long or in the wrong combination, they can be harmful. Deprescribing is increasingly used by healthcare professionals to regain control.

Banning Drug Ads to Promote Health Joel Lexchin, York University

Advertising promoting new drugs is effective but often leads to inappropriate prescriptions. To protect the health of their citizens, countries should ban it.

The untapped potential of effective non-drug therapies By Paul Glasziou, Bond University

Compiled by the Royal Australian College of General Practitioners, HANDI is the world’s premier compendium of drug-free medical treatment.

Not Just the Big Pharma: How Social Factors Affect Overprescribing in India

By Paromita Goswami, Shiv Nadar University and Anindita Chaudhuri, University of Calcutta

The increasing use of antidepressants in India is not only due to the marketing of pharmaceutical companies. Social stigma and the economy drive people to take the pill.

Medication Package and Forgetting in Elderly Care By Simon Bell, Monash University

Nowhere is the problem of overprescribing more acute than in nursing homes where experts grapple with the overuse of mind-altering drugs and other potent drugs. (360info.org)

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