Government pledges to reduce over-prescribing of drugs
- Government-commissioned review estimates 10% of items distributed in primary care are over-prescribed, with 15% of people taking five or more drugs per day, increasing risk of side effects
- About 1 in 5 hospitalizations in people over 65 are due to adverse drug reactions
- Ministers accept all recommendations, including the introduction of a new national clinical director for prescribing, increased use of social prescribing and a better transition between hospitals and the community
The government will take action to prevent drugs from being unnecessarily prescribed in England as a new review highlights the impact of overprescribing.
Led by UK pharmaceutical director Dr Keith Ridge CBE, the government-commissioned review of overprescribing – released today – found that 10% of the volume of prescription items dispensed in primary care in England is either inappropriate for the circumstances and wishes of these patients, or could be better served with alternative treatments.
Overprescribing describes a situation where people are given drugs they don’t need or want, or where the potential harm outweighs the benefits of the drug. This can happen when a better alternative is available but not prescribed, the drug is appropriate for a condition but not for the individual 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.
About 1 in 5 hospitalizations in people over 65 and about 6.5% of total hospitalizations are due to adverse drug reactions. The more medicines a person takes, the more likely it is that one or more of these medicines will have an unwanted or harmful effect. Some medicines, such as those to lower blood pressure, can also increase the risk of falls in the elderly and frail.
The review presents a series of practical and cultural changes to ensure that patients receive the most appropriate treatment for their needs while ensuring that clinicians’ time is well spent and that taxpayer dollars are spent. advisedly. This includes shared decision-making with patients on whether to start or stop a drug, better use of technology, ways to review prescriptions more effectively, and consideration of alternative medicines that would be more effective.
The ministers accepted all the recommendations and work will now begin to implement them, as reforms to the training of pharmacists are already underway.
Health and Social Affairs Secretary Sajid Javid said:
This is an extremely important review that will have a lasting impact on people’s lives and improve the way drugs are prescribed.
With 15% of people taking 5 or more drugs per day, in some cases to cope with side effects of another drug, more needs to be done to listen to patients and help clinical teams fight overprescribing.
I look forward to working with Dr Keith Ridge and our dedicated NHS teams to implement these recommendations.
Dr Keith Ridge CBE, Chief Pharmaceutical Officer for England, said:
Drugs do people a lot of good, and the practical steps outlined in this report will help clinicians ensure that people receive the right kind and amount of drugs, which is better for patients and also benefits taxpayers, by avoiding unnecessary spending on prescriptions.
This report recognizes the NHS ‘strong track record in evidence-based drug use, through the clinical expertise of GPs and pharmacists and their teams, and our achievements to date in tackling overprescribing which is a global problem.
Continuing to fight overprescribing requires a holistic, systems approach involving clinicians and patients, so that we can continue to build the change we all want to see in the way drugs are used for the benefit of patients, and with the production and the use of drugs as a major contributor to greenhouse gas emissions – contributing to the net zero ambition of the NHS.
The main recommendations of the review are as follows:
- the introduction of a new national clinical director for prescribing to lead a 3-year program comprising research and training to help enable effective prescribing;
- system-wide changes to improve patient records, improve handoffs between primary and secondary care, develop a national toolkit, and provide training to help general practices improve consistency in repeat prescribing processes;
- improving the evidence base for the safe withdrawal of inappropriate medications (deprescribing) and updating clinical guidelines to support more patient-centered care. This would include ensuring that general practitioners have the data and medical records they need, and are empowered to challenge and modify prescriptions made in hospitals;
- cultural shifts to reduce drug dependence and support shared decision-making between clinicians and patients, including increased use of social prescribing, which involves helping patients improve their health and well-being -being by connecting them to community services that could be run by the council or a local charity.
- providing clear information on the NHS website for patients about their medicines and creating a platform for patients to provide information on the effectiveness and side effects of their medicines; and
- developing interventions to reduce waste and help achieve NHS net zero carbon emissions. The journal also calls for more research to investigate the reasons why overprescribing is more likely to affect older people, people from ethnic minority communities and people with disabilities.
Health Minister Lord Syed Kamall said:
This essential review is an important step forward that will benefit patients across the country, and we will help ensure busy primary care teams are supported by improved systems and resources.
Whether it’s helping to change a culture of demand for drugs that aren’t needed, providing better alternatives, and preventing health problems in the first place, we’ll be taking a series of steps to act on this. exam.
The review concludes that the key to stopping overprescribing is making sure that patients are prescribed the right drugs, at the right time, at the right doses, known as âdrug optimizationâ. He also notes that reducing excessive prescribing will help the NHS meet its commitment to become net zero carbon, as the production and use of certain drugs can generate significant greenhouse gas emissions. Currently 25% of the NHS ‘carbon footprint is due to drugs, in part the use of anesthetic gases and inhalers, but this is mostly caused by manufacturing and freight in the supply chain.
The causes of overprescribing drugs are complex due to a range of systemic and cultural factors. Significant progress has been made in this area in recent years, thanks to the hard work of general practitioners, pharmacists and their teams.
This includes the rapid expansion of clinical pharmacists working alongside general practitioners to review drugs, and the shift to more personalized care, shared decision-making between patients and staff, and increased social prescribing.