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Basic principles

What are the tenets that underpin our approach? A scientific spirit, respect for the evidence, tempered by scepticism. Humility, empathy and unwavering devotion to the patient’s interests. Most crucial perhaps is independence.

Health information

Honest and reliable information supposes transparent sources of funding, shielding editorial choices from partisan or commercial pressures. It also supposes that authors are not allowed to be both judge and judged.

A firm foothold

Day-to-day medical practice is full of pitfalls. Reliance on solid evidence is a good way to avoid many of them.

Health professionals and patients: the best alliance

The alliance of health professionals and health service users is the most promising approach to improve the quality of care and uphold patient choice.

Just who are we working for?

Just who are we working for? And at the end of the day, whose interests are we defending? In the face of constant pressure from the media, advertising and government, healthcare professionals need to stop and ask themselves these questions.

Preventing the preventable

Analysing errors and malfunctions is one of the most direct, and most necessary, methods of achieving progress in quality of care and patient safety. Prescrire's programme "Preventing the Preventable" lets subscribers share their experiences and work out solutions, without judgement, and in total confidentiality.

Initiatives

Imagination and action are needed to open up new paths in healthcare. We should try to draw whatever relevant information we can from these initiatives, to improve healthcare professionals’ practices and continuing education, to better serve patients. This was one of the major goals of the "Rencontres Prescrire" workshop, held 30 May-1 June 2008 in Rennes, France.

Evaluate the benefits of preventive measures

All too often, through a series of miscalculations, prevention becomes a "commercial" activity, in which we lose sight of the goal of preventive care. Those who want to improve healthcare need to keep a clear head and their feet on the ground, and carefully evaluate the benefits of preventive measures.

Kept in the dark about dangerous medicines

A citizenry kept well-informed by an independent press is the best defense against the risks of medicines. Donald Light notes that the European lay media appear less interested in news on medicines than the US media. He has a point, at least as regards France.

The constant practitioner

Faced with a patient’s suffering, healthcare professionals must first listen, discuss and explain, and then offer the treatment whose harm-benefit balance is the most acceptable. Especially when the patient thinks that a drug is a miracle cure for whatever is ailing him or her at the moment: a little feel-good pill, with no adverse effects.

Knowing a disease’s natural history helps make decisions

It is vital to be aware of a disease’s natural outcome in order to make pertinent treatment decisions, in particular to define the aim of treatment.

Shocking market approval

Paliperidone, the main active metabolite of risperidone, is now approved for sale in Europe for patients with schizophrenia. Shockingly, this decision was based solely on placebo- controlled trials. Healthcare professionals must be reminded of their responsibility to help patients, and must refuse to prescribe a placebo when an effective drug is available.

Distinct and separate roles

At their core, all healthcare activities centre around the needs of individual patients who are seeking help to deal with a health problem. Any confusion between the roles of the different players in the healthcare system undermines not only overall quality of care, but also patients' freedom to base treatment choices on their individual needs.

Just what are we paid for?

Does payment reflect the value of healthcare services? It is high time that France reform its healthcare system to move toward modes of remuneration and ways of working that promote quality, instead of providing incentives for greater volume and all sorts of commercial activities.