TENS of thousands of patients in Scotland are taking drugs that put them at high risk of serious side-effects, researchers revealed today.
A study found 60,000 people have been prescribed a treatment by their doctor even though they have other health issues which mean the medicine could make them very unwell.
Internal bleeding, including strokes and kidney damage, are among the side-effects they could suffer.
The authors, from Dundee University, note adverse drug reactions frequently put patients in hospital – accounting for 6.5% of all admissions to Scots wards – and can be fatal. They hope a crackdown on high-risk prescribing by GPs and other health professionals will cut the toll.
Lead author Professor Bruce Guthrie said: “I think there is significant high-risk prescribing across the health service and I think it could be made safer. It is concerning.”
For the study the researchers investigated the drugs being taken by nearly 140,000 patients who were at particular risk of side-effects because of underlying health problems, other medicines they were taking or their age. They found 19,308 of them – nearly 14% – had been prescribed one or more potentially dangerous medicines.
Not every case will be an error or a misjudgment, according to the report on the findings in the British Medical Journal, as some patients may want to live with the risks because of the benefits derived from the treatment.
However, the researchers found the level of high-risk prescribing varied four-fold between GP surgeries. During a pilot in Tayside where doctors were asked to review patients at high risk from their drugs, about a third were taken off treatments.
Professor Guthrie said: “It is reasonable to assume a quarter to a third of these prescriptions are stoppable and maybe more if we go back and review the patients.”
He said some of the prescriptions may have been given in error – perhaps because the doctor did not have all the information about the patient at the time – but the bigger problem was a failure to reconsider if a patient needed to continue taking a high-risk drug which they may have been put on in a moment of crisis but did not need longer term.
He added that GPs were given a lot of information about how much they spent on prescriptions but little about the safety of their decisions.
He said: “Practices may therefore not be aware they are doing something different from others, and may be surprised to see they prescribe more high-risk drugs than others. We feel it would be helpful to let practices know how they compare to others and think the number of vulnerable patients being prescribed high-risk drugs can be reduced.”
Dr Dean Marshall, chairman of the British Medical Association’s Scottish General Practitioners Committee, said: “This study fails to discriminate between minor and very serious adverse reactions to drugs. Neither does it recognise the decision-making processes GPs take when dealing with patients. For each patient, the decisions vary based on the particular needs of that individual.”
He added that GPs were very aware of the risk of side-effects and received a huge amount of information automatically by computer before deciding to prescribe a particular drug.
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