Doctor, Overmedication…: how to limit risk?

The French are among the largest consumers of drugs. To limit side effects and accidents related to these products, the simplest is, where possible, limit their decision-making. Whatever the objective and the duration of the treatment, it is also essential to respect rules of good use.

According to the latest survey of health insurance in Europe on the major drug classes, the French are aware that drugs are active products that can present a risk1. They are also the largest consumer of drugs in value and the latter volume2: 42% of the more than 18 years took at least a drug all the jours1, a proportion that increases with age.

the treatment

Any drug has potential risks

If the drugs remain crucial, even vital in certain pathologies, they present potential risks, so-called adverse, which users should be aware.

“Beyond allergic risk, hardly predictable, any medication, because of its efficiency, may have adverse effects, note Bernard Delorme, pharmacist, head of the unit information for patients and the public to the Afssaps3.” “Even the paracetamol, who has proved his job security and is available in free access without order, presents a risk, small but real”.

Side effects increase with the dose, the duration of the treatment and the number of drugs. They can also be linked to the phenomenon of interaction, some drugs that can modify the activity, either by decreasing their effectiveness or by the multiplying, and the associated risks. These interactions also exist with food, beverages or plants and environmental factors.

In France, 3.6% of hospitalizations, 144 000 each year, are related to the adverse effects of drugs. One-third of them could be avoided4.

Some populations are particularly vulnerable

“The pregnant women, as a precaution to the baby, people who have a failure at the level of an organ (heart, liver, kidney, lung…)” “and the elderly must be particularly attentive to the iatrogenic risk”, warns the pharmacist.

With age, the body purification capacity declined and some organs are already weakened. However, the pathologies are also more frequent, requiring decision-making in the long course of different drugs. The 65 years and, which are 83% less than a drug every day1, are two times more accidents related to drugs than the rest of the population5. Falls, malaise or confusion, they are also more harmful.

To regularly reevaluate its treatment

“The list of drugs on the order is sometimes impressive, concedes Bernard Delorme.” The doctor is not always responsible, his patient that can be followed by various specialists. Self-medication is also to take into account. “To verify the absence of interactions, each prescribe must be kept informed of all treatment”.

According to the wishes of the person, and to minimize the risks of overdose and interactions, doctors can establish priorities and try to reduce the doses of certain drugs, or even completely remove them. Indeed, for Pr Jeanie, “whether”déprescrire”is also important that whether prescribing”6. In some cases, it is possible to offset the benefits of the drugs by playing on other parameters (diet, physical activity, relaxation…). Some people may also prefer to tolerate their symptoms to preserve their organization. Finally, sometimes for minimum treatment research allow to realize that a drug has become unnecessary.

For long or chronic pathology, it is also recommended to regular check-ups to reassess all of the treatment. Bernard Delorme insists: “this assessment must be made with a doctor, general practitioner or specialist, who, if he decides to discontinue a drug, does often gradually by ensuring that the patient remains well balanced.” “Some treatments and, among the most common, those prescribed for diabetes, high blood pressure, heart disease, asthma, thyroid problems, epilepsy or psychiatric conditions… should never be interrupted without medical advice.” To the risks that would result in their absence, it may be necessary to prosecute them life.