Editorial: always ask about the medicine

Photo: Andres Teiss

In Postimees, today, Tallinn University professor Airi Värnik laid out main problems related to side effects and combined effects of medicines. A needed step towards mapping the issue.

As all know, all medicines have side effects. Most are written on the package leaflet included. Largely, these have been discovered by testing, while feedback by patients does play a role. Carefully reading the leaflet, it says please let us know of side effects. Statistically speaking, with about 11 million prescriptions issued in Estonia over a year, studies show severe complications related to medicine number around a hundred thousand. And yet, underlines Airi Värnik, feedback and relevant reports are rare. And therefore, as needed feedback never comes, information remains elusive on how to make use of medicines safer.

The other problem is combined effect of medicines, their interaction. While effects of medicines on organism has been studied more diligently, interactions with other medicines less so. The reason is simple: medicines used are so incredibly numerous that any company developing a new one faces an impossibility. It’s not possible to study interactions thereof with all existing medicine groups. Meanwhile, it is hard to predict how varying medicines will interact in a human body.

But this is just a part of the problem. The other part is doctor-patient communication. Even with a measure of knowledge of interaction of certain medicines, what’s the use if a doctor prescribing you something knows not of other ones you are using. The doctor will not always ask, and the patient does not always think to tell her. The former is always busy, and the other perhaps just forgot – or thought it wasn’t important. A pharmacist might help, as one knowing enough of medicines but that would spell added load – more time would be needed to communicate with the patient and at times to call the doctor. True, e-health would perhaps help here but it is not working broadly enough as yet.

Elsewhere in the world, assistance is provided by combined effects database – not used in Estonia as yet. But that has its own problems. In her article, Ms Värnik tells how the pharmaceutical industry is under constant financial pressure to rather develop new medicines instead of continuing to produce the old ones – the cheaper copies of the latter undermine profitability. That, in turn, spells constant need to update the database.

So what do we say? The patient needs to be active and ask, ask, ask. And, always remember: every visit to a doctor needs not end by prescription of a new medicine. Perhaps, time to switch from treatment towards health promotion and prevention of sicknesses? Not limited to giving Health Insurance Fund a break, folks would be a lot healthier.