Healthy Skepticism Library item: 7765

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Publication type: Journal Article

Baqir W, Maguire A.
Doctors' and pharmacists' attitudes to the use of sugar-free and sugar-containing medicines in the elderly
International Journal of Pharmacy Practice 2001; 9:(3):177-184

Abstract:

Background – Much progress has been made towards the prescribing and dispensing of sugar-free alternatives for medicines used long-term in children. However, older people may also take sugar-containing medicines and those with natural teeth are at risk of dental caries. Objective – To assess the knowledge and attitudes of health professionals with regard to the use of sugar-free medicines with prolonged oral clearance in elderly people. Method – Postal questionnaire survey of three groups of health professionals (general practitioners, community pharmacists, consultant geriatricians). Statistical analysis using factor analysis, Mann Whitney U test and Kruskal Wallis test. Setting – Five districts of north-east England. Key findings – The overall response rate was 66 per cent (349 responses). Support for the use of sugar-free medicines was greater among GPs than pharmacists (P=0.014). There was general agreement that, wherever possible, pharmacists should dispense sugar-free medicines for elderly people, although more GPs (P<0.0001) and consultant geriatricians (P=0.024) agreed than pharmacists. More pharmacists than GPs believed sugar-free medicines to be more expensive although there was general uncertainty about whether this deters doctors and pharmacists from using them. There was a good understanding of the role of sugars in medicines in the aetiology of dental disease, although respondents felt that elderly people were unaware of this link. Only 51 per cent of respondents agreed that government should subsidise sugar-free medicines production. Ninety-four per cent felt that the pharmaceutical industry should produce more sugar-free products. Conclusion – Although there is support for the sugar-free option, there is a need to raise the awareness of health professionals to barriers which currently discourage utilisation, and to encourage a more multi-professional approach in the education of health professionals, health care providers, manufacturers and regulators with regard to sugar control in medicines use and related regulatory issues.