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Doctors pressured to prescribe unfamiliar drugs

1 May 2013

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Doctors should not feel pressurised into prescribing unfamiliar drugs when dealing with the aftercare of patients who have received treatment abroad. 

UK-wide medical defence organisation MDDUS has dealt with a growing number of calls from members seeking advice on responding to requests by patients to prescribe medication recommended by overseas doctors.

Some of these medications are not licensed in this country. 

MDDUS medical adviser Dr Mary Peddie said doctors should treat such requests in the same way as if the recommendation came from a UK specialist. 

She said: “Doctors must be prepared to explain and justify their decisions and actions when prescribing, administering and managing medicines. 

“This advice also applies to patients who purchase medicines on the internet and wish the GP or practice nurse to administer injections.” 

The cases often involve patients going overseas for fertility treatment and finding there are lower costs for IVF treatment. 

Dr Peddie added: “On their return, some patients want their GP to provide medication which, in the UK, is usually provided by the specialist unit. The medication recommended may not be in use in this country, or may even be unlicensed here.”

The GMC guidance requires that if a doctor prescribes on the recommendation of another doctor or health professional, he or she must satisfy themselves that the prescription is needed, is appropriate for the patient and is within the limits of the prescriber’s competence. 

This guidance is equally applicable whether or not the treatment is being recommended by someone outside of the UK.

One of the difficulties which can arise with recommendation from abroad is in the differing treatments and drugs used.

“We have handled cases where doctors have received patient requests for medication recommended to them in another country but the drug is either not licensed in the UK or the recommended preparation or dosage differs,” Dr Peddie said. 

Doctors must provide effective treatments based on the best available evidence. GMC guidance Good Medical Practice states: “Prescribe drugs or treatment only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs.”