I recently stumbled upon a very interesting editorial opinion in the ‘European Journal of Clinical Pharmacology’: ‘The use of drugs is not as rational as we believe…but it can’t be! The emotional roots of prescribing’, authored by Albert Figueras, from Fundació Institut Català de Farmacologia (Catalonia Institute of Pharmacology Foundation at Vall d’Hebron Hospital, in Barcelona).
Since more than 40 years ago when Archie Cochrane said that “there must be solid scientific evidence behind any statement, decision and prescription made by medical staff”, and all the way until today’s WHO promotion of rational medicine utilization, both developing and industrialised countries have been striving to increase sound knowledge about prescription and thus spread the kind of rational thinking necessary to foster evidence-based medicine in drug use.
Keeping your skills up to date has never been an easy task but nowadays we have newsletters and other Internet tools that can grant any MD state-of-the-art knowledge on any subject he or she may need, accessible anywhere and for any medical speciality. Nevertheless, drug use in the “real world” is far from this high quality. Not only in Spain: it has been noted in France, Greece and other countries that, despite widespread knowledge of risk factors that may cause gastrointestinal toxicity in patients under nonsteroidal anti-inflammatory drugs (NSAID) treatment, there is a massive use of proton-pump inhibitors in individuals that show no significant risk.
Changing well-established drugs for newer, less-known products is not consistent with the need of a well-grounded comparative evaluation. We are not raising concern on the influence of gifts or invitations from pharmaceutical companies. Many doctors really want to make rational decisions… but can’t. Read more »
*This blog post was originally published at Diario Medico*