Volume 184 - Issue 2
Use of prescribed medications in a South Australian community sample
Author: Rohan A Elliott
Med J Aust 2006; 184 (2): 96. || doi: 10.5694/j.1326-5377.2006.tb00139.x
Published online: 16 January 2006
Published online: 16 January 2006
To the Editor: Goldney and Fisher recently reported data on medication use in an Australian community sample and estimated the financial savings that could be made if the number of prescribed medications was reduced.1
However, the assumption that the average number of medications per patient could be reduced ignores the large body of evidence that has accumulated over recent years demonstrating under-use of beneficial medicines. Under-prescribing has been identified in the management of a broad range of chronic conditions, including heart failure, ischaemic heart disease, hypertension, atrial fibrillation, asthma, osteoporosis, pain, and depression.2,3 It has been suggested that under-use of beneficial therapies may be an even bigger problem than over-prescribing, especially in older patients.4,5
As Goldney and Fisher did not collect any clinical information about their study subjects, no conclusions can be drawn about whether medications were more frequently over-prescribed or under-prescribed. Focusing solely on reducing the number of medications prescribed may be misguided and may result in poorer health outcomes. A broader view of prescribing is required, recognising that problems result from both over- and under-prescribing, as well as inappropriate dose selection and monitoring.5
References
- Goldney RD, Fisher LJ. Use of prescribed medications in a South Australian community sample. Med J Aust 2005; 183: 251-253. 0_CBBFCBHF
- National Institute of Clinical Studies. Evidence–practice gaps report. Vol 1. Melbourne: NICS, 2003. 0_i1091548
- National Institute of Clinical Studies. Evidence–practice gaps report. Vol 2. Melbourne: NICS, 2005.
- Gurwitz JH. Improving the quality of medication use in elderly patients. A not-so-simple prescription. Arch Intern Med 2002; 162: 1670-1672. 0_i1091552
- Rochon PA, Gurwitz JH. Prescribing for seniors. Neither too much nor too little. JAMA 1999; 281: 113-115. 0_CBBFBFEI