Government review identifies harmful impact of overprescription

A healthcare improvement expert based at the University of Leicester has contributed to a new Government report which suggests many patients are being prescribed unnecessary and even harmful treatments.

The National Overprescribing Review, published today (Wednesday) by the Department of Health and Social Care, estimates that ‘at least 10% of the total number of prescription items in primary care need not have been issued’.

Close to 15% of people in England take five or more medicines a day – some are to deal with the side-effects of others.

Professor Natalie Armstrong is a Professor of Healthcare Improvement Research & Health Foundation Improvement Science Fellow at the University of Leicester and contributed to the report.

She said: “I was really pleased to be invited to join the working group for this important review. It tied in really well with work I was doing on overuse as part of my Health Foundation-funded Improvement Science Fellowship.

“The importance the review places on the systemic and cultural factors that contribute to overprescribing is really welcome. Better understanding these issues will be key to making progress.”

Overprescribing is a serious problem in health systems internationally that has grown dramatically over the last 25 years. The report identifies systemic causes, like a lack of alternatives to prescribing a medicine or an inability to access comprehensive patient records, plus a healthcare culture ‘that favours medicines over alternatives and in which some patients struggle to be heard’.

The review therefore proposes:

• systemic changes to improve patient records, transfers of care and clinical guidance to support more patient-centred care
• culture change to reduce the reliance on medicines and support shared decision-making
• a new National Clinical Director for Prescribing to lead a cross-system implementation programme including research and training

One knock-on effect of overprescription is an increase in antibiotic resistance, meaning individuals may not respond to certain treatments.

Leicester researcher Professor Martha Clokie is pioneering bacteriophage therapy to help combat this problem, and transform how bacterial infections are treated.