High risk patients and prescription drugs

Latest Study a Real Eye-Opener

It’s difficult to gauge how concerned we should be about information recently uncovered by a team of scientists from the University of Dundee and reported in the British Medical Journal. At first glance, the news is alarming. But in fact, the situation is more common than people realize.

The “situation” being addressed in this report is the number of patients who are prescribed high-risk drugs and then end up hospitalized because of side effects that should be preventable. Of the records reviewed by these scientists, nearly 140,000 individuals were found to be “high-risk” patients either because of their age, or because of a pre-existing condition or other reason. Further research of these records revealed that in the last year, doctors had prescribed a high-risk drug to nearly 20,000 of those high-risk patients.

The information used to compile these statistics was uncovered after reviewing data and prescription records from 315 general practices located in Scotland. Nearly one-third of all of the people living in Scotland are registered at these 315 practices.

Sounds like cause for concern

But it may not be. To make it easier to understand why these statistics may not be as alarming as they sound, it is important to understand why doctors prescribe high-risk drugs to some high-risk patients. Oftentimes, they do it because the benefits of doing so outweigh the potential risks. This is common in situations where the GP has determined that there is no other “correct” course of treatment for a patient. When a patient’s treatment options are limited, even patients agree that taking a potentially risky medication is an acceptable option.

Sometimes though, this situation happens by mistake. A good example of this is prescribing anti-inflammatory drugs to patients with known health issues like ulcers or problems with their kidneys. Another example involves prescribing antipsychotic drugs to dementia patients. Situations like these and plenty of others really should not happen. But unfortunately they do because doctors are human and even they make mistakes.

Interestingly, the scientists involved in this latest study were not so concerned with the actual practice of prescribing high-risk drugs to some high-risk patients. As observed in their research, this type of high-risk prescribing was fairly common.  What scientists expressed more concern over were the discrepancies they noted among the different medical practices that allow this to happen.

Without more consistency in deciding the health situations in which prescribing high-risk drugs to some high-risk patients is acceptable and when it is unacceptable, they fear even more patients will be put at unnecessary risk of hospitalization, or worse – death.

In their opinion, their research clearly shows that there are considerable opportunities to improve drug prescribing safety. One such opportunity is the development of uniform prescribing guidelines; something they believe will greatly reduce these risks. The scientists hope that the research they compiled will open a lot of people’s eyes to the need for more consistency in prescribing practices among GPs so that appropriate steps to address this problem get underway sooner rather than later.

What do you think?