Quality care means constantly sifting through the latest treatments on offer and not mistaking commercial innovation for genuine progress. It means distinguishing between wrong, biased or useless information and solid, proven, operational evidence.
2009’s crop included its share of innovations that were misleading or represented a step backwards rather than forward.
The Prescrire review is practical for use by healthcare professionals. Drugs are grouped by families and then sorted under the following headings:
- "of note for your prescriptions list" (e.g. myeloma in the elderly: some improvement with the addition of thalidomide);
- "improving treatment" (e.g. no angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists for women of reproductive age);
- "judgement reserved" (e.g. aerodigestive-tract cancers where traditional treatments fail: temoporfine needs to be better evaluated);
- "remove from your prescriptions list" (e.g. etoricoxib: unfavourable risk-benefit balance);
- "considering drug-related adverse effects" (e.g. renal failure and fatalities with erlotinib);
- "do not use" (e.g. oral contraception: estradiol does not represent an improvement);
- "educating healthcare professionals and patients" (e.g. no vitamin B+ folic acid in cardiovascular prevention).
©Prescrire May 2010
"From Prescrire's 2009 drug review: a recap of which new drugs to avoid" Prescrire Int 2010; 19 (106): 76-80 (pdf, subscribers only).