Expert advice

Medicines management: How can we reduce unnecessary medication prescriptions?

All medicines have the potential to cause harm to patients. Before prescribing any medication, consider whether the patient really needs it, and look for non-pharmacological interventions first where possible, says medicines management expert Matt Griffiths. 
prescribe

All medicines have the potential to cause harm to patients. Before prescribing any medication, consider whether the patient really needs it, and look for non-pharmacological interventions first where possible, says medicines management expert Matt Griffiths

Prescribing medicines is very easy in modern times. In many cases, we dont even have to write a prescription just a few clicks of a mouse can start a whole chain of events for patients, affecting their lives more than we can imagine.

Although it is easy to look for a quick pharmacological fix, before prescribing or administering any medication consider carefully whether the patient really needs it. Are there non-pharmacological interventions we can try first? Are there any contraindications or cautions to prescribing the medicine that we need to be aware of?

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All medicines have the potential to cause harm to patients. Before prescribing any medication, consider whether the patient really needs it, and look for non-pharmacological interventions first where possible, says medicines management expert Matt Griffiths

prescribe
Prescribing professionals must do their bit to reduce
unnecessary prescriptions. Picture: Alamy 

Prescribing medicines is very easy in modern times. In many cases, we don’t even have to write a prescription – just a few clicks of a mouse can start a whole chain of events for patients, affecting their lives more than we can imagine.

Although it is easy to look for a quick pharmacological fix, before prescribing or administering any medication consider carefully whether the patient really needs it. Are there non-pharmacological interventions we can try first? Are there any contraindications or cautions to prescribing the medicine that we need to be aware of?

Every medicine has side effects, and the potential to cause harm to patients. Some medicines can also cause drug-on-drug reactions. The British National Formulary is a great source of information for checking this – you can look up an individual medicine in the BNF and then use the appendix to see whether it might affect the patient’s current medications.

The medicines compendium available at the electronic Medicines Compendium (eMC) is also a great help. If you type in the name of a medicine – brand or generic – the summary of product characteristics (SPC) and patient information leaflet (PIL) will appear.

Potential harm

The SPCs contain all the licensing information on that particular medicine, with in-depth information including, in many cases, the prevalence of different types of side effect. PILs are available with dispensed medications and can be an excellent source of information for patients.

Polypharmacy is also a major issue in today's healthcare environment, with many hospital admissions relating to polypharmacy issues.

As prescribing professionals we need to do our bit to reduce unnecessary prescriptions and be constantly aware that they have the potential to cause harm to patients.

Regular medicines management reviews should be carried out so we can assess the risks and benefits of medicines and ensure we are acting in patients’ best interests. This also enables us to stop certain medicines, with the patient’s agreement, if it is safe to do so.


Matt Griffiths is visiting professor of prescribing and medicines management at Birmingham City University 
 

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