Public Health England has released its review into prescribed medicines, acknowledging that a lot of recommendations may have already started or will do shortly – partly because of what prompted the review or knowledge of the review itself.
The review aims to make sure the healthcare system builds awareness and enhances decision making. It covers adults taking benzodiazepines, z-drugs, gabapentinoids, opioids for non-chronic cancer pain and antidepressants. At the end of March 2018, the findings showed half of the people using the prescribed medication had been on them for at least 12 months.
The recommendations from PHE falls into five broad categories which are:
- Increasing the availability and use of data on the prescribing of medicines that can cause dependence or withdrawal to support greater transparency and accountability and help ensure practice is consistent and in line with guidance.
- Enhancing clinical guidance and the likelihood it will be followed.
- Improving information for patients and carers on prescribed medicines and other treatments, and increasing informed choice and shared decision-making between clinicians and patients.
- Improving the support available from the healthcare system for patients experiencing dependence on, or withdrawal from, prescribed medicines.
- Further research on the prevention and treatment of dependence on, and withdrawal from, prescribed medicines.
The report concluded that longer-time prescribing is widespread and that aside from antidepressants the medications should be used for short-term treatment of acute conditions. It also highlights that long-term prescribing of opioids for chronic, non-cancer pain is not effective for most patients.
It also calls for increased public and clinical awareness of other interventions such as cognitive behavioural therapy.
Commenting on the report, Dr Sheuli Porkess, executive director, research, medical and innovation at the Association of the British Pharmaceutical Industry (ABPI), said: “This important report paints a picture of how these medicines are being used across the UK.
“Medicines prescribed for pain, depression and insomnia support millions of people every day. But it’s critical that they are used in the right way and that regular reviews give patients the support they need to come off a medicine when necessary.
“Pharmaceutical companies are fully committed to playing their part. We’re working with the MHRA, Public Health England and other professional bodies to help make sure that all medicines are prescribed and used safely and appropriately.”
Darren Nichols, managing director of First DataBank (FDB), explains that despite not featuring heavily in the review, technology can have a big role in primary care prescribing.
He said: "Today we are working with more than 4,000 GP practices, with a patient population of 35 million, across two thirds of England’s clinical commissioning groups (CCGs) who are making significant strides in changing prescribing practice, by drawing on technology at the point of prescribing. This enables clinicians to be alerted when a prescribing decision might not comply with clinical best practice or when it might not be most appropriate for the individual patient. This has already seen thousands of GPs choose alternative medications for their patients millions of times.
“Technology like this will continue to be an essential support for GPs, and to CCGs, in helping to distil current and improved guidance around medicines examined in Public Health England’s report, and in adhering to it when appropriate. This can help to ensure greater compliance with guidance, whilst ensuring professionals remain in control of informed prescribing decisions."
You can read the full Public Health England report, here.