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GPs “prescribing older people too much medicine”

4 March 2009

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The GP incentive scheme is to blame for turning “reasonably well” older people into patients, according to a leading doctor.

Michael Oliver, professor in cardiology at the University of Edinburgh, believes the “tick-box” culture surrounding GP surgeries means older people are being prescribed too many pills which could prove harmful.

He said the Quality and Outcomes Framework meant many of the older generation were invited for health checks and often went home with pills, despite feeling reasonably well.

His article entitled Personal View, published in the British Medical Journal, warned that “scant attention” was being paid to potential side effects, such as the vertigo induced by some blood pressure drugs, and the lethargy linked to beta blockers.

Professor Oliver also said many people taking statins to lower cholesterol suffer muscular discomfort or weakness.

He said: “What kind of medicine is this? It is politics taking preference over professionalism, obsession with government targets superseding common sense, paternalism replacing personal advice.”

Copyright © Press Association 2009

British Medical Journal

Do you agree with Professor Oliver? Your comments (terms and conditions apply):

“Yes, I have just been diagnosed as diabetic. I have all the symptoms, but my blood sugar is only slighty higher than the guidelines (and was within it before they lowered it last year). I have been given a low dose of metformin and am to return in one month, at which point I will be prescribed tablets for high blood pressure, cholesterol and an aspirin. They have not even done a blood test on me for cholesterol and since I have lost 4 pounds in less than a week on my diet, I really don’t think I
will need one” – Sue, Salford

“Yes, Professor Oliver has highlighted the issue that is often a concern for GPs in practice. QOF almost forces GPs to prescribe medication that they otherwise might not necessarily prescribe and it’s only set to get worse. The latest guidance for QOF 2009/2010 adds even more drugs to the targets, eg, CKD indicator; patients on ARB or ACEi now also have to be prescribed a beta blocker. QOF takes away the clinical decisions from GPs if they want to get paid for the services they provide” – Angela Williams, Gwent

“Yes” – Dr Bhimani, Orkney

“Yes, I do feel that many patients are being prescribed with too many types of pills for a problem that they have. I myself have a problem with high blood pressure and angina. At present I am taking different types of medication that my GP prescribed. They are Viazem-nicorandil-isosorbide-dipyridamole. I am also taking medication for a gastric problem, which is omeprazole. Am I being overprescribed?” – Charles Reddall, Staffs