Mistura highlight UK medication risks and importance of patient choice
As the general election race hots up, it is the NHS that is dominating the field of political debate alongside the Brexit saga. Every major party is promising to pump money into the health service, but there are other major issues to consider outside of funding. One of these is education on medication and its impact on some of the most vulnerable in society.
The House of Lords science and technology committee drew attention to this at a recent hearing. Professor of molecular and clinical pharmacology at Liverpool University, Sir Munir Pirmohamed, told the committee how many of his elderly patients were prescribed dozens of drugs at the same time, without extensive testing on their lasting impact on an elderly patient. Sir Munir said,
“Those drugs are used at conventional doses and those doses have been tested in younger populations who had exclusion criteria for trials – so they have been tested in people who don’t have the multiple diseases... So when we use a drug at a dose which is licensed at the moment, we are often ‘poisoning’ the elderly because of the dosing that we are using.”
The UK has an ageing population, ever more reliant on the NHS as people live longer. Statistically speaking those people will be on multiple medications at one time for current and legacy illnesses. Even younger members of the population regularly receive prescriptions from their doctor for a range of ailments and conditions. The Parliamentary Review spoke to Dr Dawn Price, managing director of Mistura whose customers include the NHS, private and third-sector healthcare organisations in the UK, Australia and New Zealand. Dr Price said,
"Medicine taking does have risks, with adverse reactions costing £530 million in hospital admissions and responsible for around 700 deaths per year. Tackling patient understanding of their medicines is key to improving adherence and can prevent hospital admission from adverse reactions. This is further complicated by unsafe practice whereby important facts about medicines are not always provided. For example, in 2017 in the UK 20,000 children were harmed when parents were not made aware of the risks of taking the epilepsy drug Valproate, and dozens of fire deaths across England were linked to the unsafe use of paraffin skin creams.
"Our unique company structure combines the creation and management of up-to-date medication information authored by national healthcare experts, within specially designed software applications. Patients need this independent expert service as online information is commonly inaccurate, out of date and often funded by advertising or drug companies."
Nowadays, patients are far more knowledgeable about their own health conditions, and web forums and social media mean they have a vast pool of patient experience taking medications to be able to challenge or question prescriptions. Patient choice is something which Dr Price and Mistura are also keen to champion,
"Mistura Enterprise recently won a prestigious grant, in partnership with the University of Sunderland, to build a Patient Decision Aid (PDA) called 'Whatsmychoice?'. Funded by Innovate, the UK government’s digital strategy arm, the platform will allow a patient to compare all medications available for treating a diagnosed condition. The project is part of a new extension to MaPPs to deliver a novel Adherence Monitoring System.
"This includes side effects and benefits of each medication important for considering the impact for individual patients. The first phase of development will deliver an 'app' in the App stores for patients to support 'shared decision making' in mental health, then rolling out to other condition areas."
More doctors, nurses and equipment will almost certainly be in the main parties' electoral plans, but technology and increasing patient choice are an equally important part of the debate.