Overprescribing of drugs ‘chronic’ in Europe

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Salzburg Medical University, Austria, is the latest body to report the ‘chronic’ overprescribing of drugs for the elderly in Europe. The study found that 36% of prescriptions given to patients with an average age of 82 years were unnecessary, while 30% of drugs prescribed were found to be inappropriate.

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The background to this is that more drugs and investigative procedures are now available than ever before. So it is tempting for a doctor to over-investigate a problem rather than advise the patient to go to bed with a hot drink, or take more exercise and keep to a healthy diet. Of course the availability of MRI scans and angioplasty, for example, is great for those seriously ill patients who need thorough investigation, but where should we draw the line? Many doctors might find it a difficult ethical situation.

So while considerable effort is being put into avoiding polypharmacy and antipsychotic drugs in particular, in elderly patients, new drugs continually arrive that may find widespread application. Take for example Roche’s gantenerumab. This has been found in phase I studies to safely remove amyloid plaques from the brain of patients with Alzheimer's disease. Whether or not it will help Alzheimer’s sufferers is quite a different question. But already patients are being recruited for a trial to evaluate the efficacy and safety of gantenerumab in patients in the early or prodromal stage of Alzheimer’s disease. Assuming it, or similar drugs, receive marketing approval, how long will it be before millions of ‘worried well’ are requesting it from their physicians?

Source: EHFG, Roche

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