Summary

• To help healthcare professionals and patients choose high-quality treatments that minimise the risk of adverse effects, we have updated our list of drugs to avoid in early 2015.
   
• Prescrire’s assessments of the harm-benefit balance of new drugs and indications are based on a rigorous procedure that includes a systematic and reproducible literature search; identification of patient-relevant outcomes; prioritisation of the supporting data based on the strength of evidence; comparison with standard treatments; and an analysis of both known and potential adverse effects.
   
• This 2015 review of medications examined in these pages over a five-year period, from 2010 to 2014, identified 71 drugs that are more harmful than beneficial in all their authorised indications.
   
• Other drugs with a better harm-benefit balance are available in most cases (when drug therapy is really necessary), but sometimes there is no satisfactory medical treatment. However, even in serious situations there is no justification for exposing patients to a risk of severe adverse effects by prescribing a drug with no proven clinical efficacy. Some of these drugs may be worth testing in clinical trials, but patients enrolled in such studies must be aware that the harms and benefits they may experience are uncertain and that the main reason for their participation is to advance medical knowledge. Tailored supportive care is the best option when there are no available treatments capable of improving prognosis or quality of life, beyond the placebo effect.

Full text available for free download.

 ©Prescrire 1 March 2015

"Towards better patient care: drugs to avoid in 2015" Prescrire Int 2015; 24 (158): 78-1–78-6. (pdf, free).