Concern over patients prescribed ‘high risk’ drugs

THOUSANDS of patients in Scotland are being prescribed drugs with a high risk of side effects, according to new research.

A team at the University of Dundee analysed prescribing data from 315 Scottish general practices with 1.76million patients. They found that 139,404 of these patients (7.9 per cent) were ‘at risk’ of receiving a drug that could harm them due to their age, pre-existing disease or co-prescription. Of these patients, 19,308 had been prescribed at least one drug that could harm them in the previous year.

Rates of high-risk prescribing varied approximately four fold between practices, even after patients' differences were accounted for.

Professor Bruce Guthrie, who led the research, said: “Our study looked at a sample of about a third of Scottish patients. If you take this across the whole of Scotland, then approximately 60,000 people particularly vulnerable to side effects might be being prescribed high risk drugs.

“This may be the correct course of action and bring benefits to the patient but it has to be balanced against the dangers. We're not saying that all this type of prescribing should not be happening, but that we have to be satisfied that it’s appropriate and ensure that doing so doesn’t put the patient at more risk.”

Researchers pinpointed cases using 15 individual indicators, including the use of antipsychotic drugs in people with dementia, prescription of non-steroidal anti-inflammatory drugs like Ibuprofen to people with previous stomach ulcers or kidney problems, and prescription of drugs recommended to be avoided in people with heart failure.

Professor Guthrie said the results of the study suggest “there is scope to make prescribing safer”. He recommended that practices are given feedback on how their prescribing compares to other practices. His team are now planning research into the effectiveness of prescribing guidelines.