IN MY VIEW... It’s vital your pills are reviewed

REGULAR reviews of a patient’s drug prescription list are an essential component of good medical care. They can indicate the need to discontinue drugs, switch to something potentially safer, change the dose or even add a new drug.

Recently, the chief pharmaceutical officer for NHS England, Dr Keith Ridge, released a report which saw the Government pledge to reduce overprescribing, as it’s estimated that 15 per cent of people take five or more medicines every day.

Taking multiple medications, even if each one is prescribed appropriately, is fraught with potential danger. A lack of continuity of care — seeing the same doctor for regular treatment — means avoidable adverse drug events are all too easily missed.

The report found that around one in five hospital admissions in over-65s is caused by such events — a shocking statistic. These days, computer-generated prescriptions can detect potential adverse interactions before they happen and issue an alert, so it’s all the more surprising that so many complications continue to occur.

Most patients on multiple drugs are older — our metabolism changes as we age and there is decreased drug clearance due to the natural decline in both kidney and liver function.

Some drugs, especially anticholinergics (widely used for bladder conditions as well as lung disease) are known to cause a decline in cognition and mobility and are linked with an increased risk of mortality.

There is a need to strike a balance between over- and under-prescribing. This arguably requires the very elements that are currently missing in healthcare — continuity of care and precious time with the GP — so that an older patient’s mix of prescriptions can be regularly reassessed.