Healthy Skepticism Library item: 12627

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Publication type: news

Metherell M.
Drugs no longer only remedy as GPs cut scripts
The Sydney Morning Herald 2008 Jan 30
http://www.smh.com.au/news/national/drugs-no-longer-only-remedy-as-gps-cut-scripts/2008/01/29/1201369135245.html

Full text:

AUSTRALIA’S doctors, once criticised for being too ready to fire off scripts at the first whiff of a sniffle, have cut back on their drug prescriptions.

Prescriptions by general practitioners have fallen by more than 10 per cent in the past decade, according to the results of a national survey of GPs.

The drop reflects the reduced need for scripts as a result of drug treatment changes, but also may signal a cultural shift in which both patients and doctors are less likely to see a drug as the automatic remedy, according to the GP leader Tony Hobbs.

The survey by the University of Sydney and the Australian Institute of Health and Welfare shows that since 1998, GPs have reduced their prescription rate from 93.6 scripts per 100 consultations to 83.3 per 100 consultations.

Reasons are thought to include the increased over-the-counter availability of some medications and the increased number of combined medications, where the one drug can treat two or more conditions.

There has also been a significant drop in the prescription of antibiotics for respiratory diseases after a lengthy information campaign to highlight their ineffectiveness against the common cold.

The decline is the latest evidence of softening growth in pharmaceutical use after fears at the turn of the century that surging expenditure on the Pharmaceutical Benefits Scheme was becoming unsustainable.

The rise has levelled off and the PBS cost taxpayers $6.5 billion last year as volume of prescriptions rose just 0.1 per cent.

Dr Hobbs, the chairman of the federally funded Australian General Practice Network, said a growing range of anti-inflammatory and other drugs was now available without prescription. Combination drugs treating different cardiovascular conditions had reduced the need for multiple conditions. And common contraceptives such as implants and injections now needed to be prescribed only once every few months.

He hoped the decline in scripts for upper respiratory tract infections was a direct result of the education campaign to promote quality use of medicines.

There appeared to be a recognition among doctors and patients that “lifestyle interventions” such as attention to exercise and diet was important “rather than simply going for the script pad”.

But the study found marked rises in the prescription of some drugs, reflecting the rise in cardiovascular disease, depression, cholesterol levels and diabetes.

Requests for doctors’ certificates have also increased, with GPs having to deal with nearly double the rate of requests compared with a decade ago.

GPs are seeing more baby boomers and aged patients than children as the GP workforce ages and becomes more feminised. More than a third of GPs are women and the number of GPs aged over 55 has risen by 40 per cent in the decade.

The study of GP activity summarises the results from a sample of 93,000 patient visits with 930 GPs. It also records a considerable increase since 1998 in the number of overweight and obese patients – up from 51 per cent to 58.5 per cent. The prevalence of overweight and obese children remained steady, with 10.6 per cent being obese and 18.6 per cent overweight last year.

GPs were referring more patients to specialists, particularly cardiologists and psychologists, podiatrists and dieticians.