Not so fast with that prescription, doctor
Critics say doctors should rely on fewer and more time-tested drugs and therapies instead of newer medications that have only been tested on a small number of patients.
Mon, Jun 13, 2011 at 11:28 PM
NEW YORK - U.S. doctors are too quick to reach for their prescription pads, according to a report urging them to think more about side effects and non-drug alternatives.
Nearly half of all U.S. residents have used at least one prescription drug in the past month, the Centers for Disease Control and Prevention said, and experts say over prescribing is rampant.
"Instead of the latest and greatest, we want fewer and more time-tested drugs," said Gordon Schiff, associate director of the Center for Patient Safety Research and Practice at Brigham and Women's Hospital in Boston, a nonprofit organization that studies ways to improve safe practices in healthcare.
"We are really trying to promote a different way of thinking about practicing," he added of the report, published in the Archives of Internal Medicine.
Widespread prescription means that more people are being exposed to side effects, sometimes fatal, without the benefits that would justify those risks.
But many doctors are quick to prescribe, partly because they have limited time to deal with individual patients or because they and their patients have been bombarded with ads from the pharmaceutical industry.
"Often what is really bothering them is not cured with a pill, but rather through exercise, physical therapy, or diet changes," Schiff said.
Yet "there are no drug reps coming to my office pushing this."
In an editorial in the same journal, researchers describe how opioid painkillers like Vicodin and Percocet have become increasingly common without good evidence that they help patients in the long run.
But in 2007 alone, there were nearly 11,500 deaths related to prescription opioids — "a number greater than that of the combination of deaths from heroin and cocaine," according to the researchers.
Some 4 million prescriptions are written for long-acting opioids each year, with side effects ranging from addiction to constipation to sleepiness.
Schiff and his colleagues urge doctors to think beyond drugs and to prescribe new ones much more cautiously, particularly since new medicine has usually only been tested on a few thousand patients by the time it hits the market — and they are often younger and healthier than those doctors see.
There is also the danger of potential interactions. More than a third of people over 60 take five or more drugs, and the number of prescriptions continues to rise.
Doctors said that it's difficult to get unbiased information about drugs, calling on the U.S. Food and Drug Administration, which approves new drugs, to issue simple summaries about them.
Schiff said that patients also have a role to play.
"Patients need to ask critical and skeptical questions, too. They should learn about the side effects of the drugs they are taking and be on the lookout for them."
Schiff's study was funded by government grants supporting consumer healthcare education and healthcare quality research.
On the Web: Archives of Internal Medicine, June 13, 2011.
(Reporting by Frederik Joelving at Reuters Health, editing by Elaine Lies)
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