and how to avoid it….
Confused about what medicines are necessary and how effective they might be?
Are statins beneficial over a certain age or not?
Are withdrawal symptoms when stopping a medicine creating a false sense of need for the medicine?
This excellent talk by Professor Dee Mangin provides an excellent overview on the ethics of prescribing and the considerations of patient priorities for care in evidenced based medicine. Dee outlines the issues involved in managing prescription medicines, especially when dealing with patients with multiple conditions.
Professor Dee Mangin, University of Otago, Christchurch and McMaster University is the the David Braley Nancy Gordon Chair in Family Medicine at McMaster University in Ontario, Canada. She is also one of the co-founders of RxISK.org.
As an advocate for better independent information for patients and their doctors on drugs, Professor Mangin has published widely on the rational use of drugs, including ‘deprescribing’ trials for polypharmacy and for individual drugs. She is co-editor of a WHO manual for medical and pharmacy students on understanding and responding to drug company promotion, as well as articles and book chapters addressing polypharmacy in older age. Dee is interested in the influence of commerce and politics on the science of medicine and was involved in a campaign to ban direct to consumer advertising of medicines in New Zealand. Dee is a frequent speaker at international conferences for family doctors with a focus on patient-centred medicine and rational drug use.
RxISK was launched in October 2012 with the goals of:
- Educating and empowering patients to have better conversations about their meds with their doctors.
- Collecting data on the unintended consequences of prescription medications so that we can draw attention to them.
RxISK is run by a group of high-profile medical experts, including Professor Mangin, all of whom have international reputations in early drug-side-effect detection and risk mitigation, pharmacovigilance, and patient-centered care.
Some startling facts from RxISK.org:
- Prescription drug spending in the US reached a whopping $329.2 billion in 2013.
- In 2011, 4.02 billion prescriptions were written in the US, with more than half of Americans on two prescription drugs.
- Drug side effects are a leading cause of death in hospitals and may be the leading cause of death outside hospitals.
- 100% of patients suffer unintended effects from their prescriptions.
- The annual cost of drug side effects is estimated to be considerably more than $100 billion, yet comprehensive, relevant data necessary to manage a solution is not collected.
- More than 95% of drug side effects go unreported, and there are serious gaps and delays in getting relevant feedback on effects of pharmaceuticals once they are released to the market.
- Regulators do not have reporting systems geared to capturing the data needed for effective post-market monitoring.
They identify two real problems here:
- There is a lopsided relationship between vulnerable patients and their doctors who have extraordinary power and knowledge over them.
- The systems and organizations we all rely on to keep us safe are fundamentally broken.
Their Mission: Making medicines safer for all of us.
RxISK Interaction tracker: http://rxisk.org/tools/interaction-checker/
RxISK Drug checklist: http://rxisk.org/tools/drug-checklist/
RxISK Polypharmacy Index: http://rxisk.org/tools/polypharmacy-index/