Abstract

• To make it easier to choose quality care, and to prevent disproportionate harm to patients, Prescrire has published its annual update of drugs to avoid.
   
• Prescrire's assessments of the harm-benefit balance of drugs in given situations are based on a rigourous procedure involving a systematic and reproducible literature search, results based on patient-relevant outcomes, prioritisation of the supporting data based on the strength of evidence, comparison with standard treatment (if one exists), and taking into account known and potential adverse effects, as well as the uncertainties surrounding them.
   
• This annual review of drugs to avoid covers all the drugs examined by Prescrire between 2010 and 2019 that are authorised in the European Union or in France. We identified 105 drugs (92 of which are marketed in France) that are more harmful than beneficial in all their approved indications.
   
• In most cases, when drug therapy appears to be the best course of action, other drugs with a better harm-benefit balance are available.
   
• Even if a patient has a serious condition for which no effective treatment exists, there is no justification for prescribing a drug with no proven efficacy that provokes severe adverse effects. It is sometimes acceptable to test these drugs in clinical trials, but patients must be informed of the uncertainties over their harm-benefit balance as well as the trial's objectives. If this option is not chosen, appropriate support and symptomatic care should be implemented when there are no effective treatments for improving the prognosis or quality of life.

©Prescrire 1 February 2020

 > FREE PDF  "Towards better patient care: drugs to avoid in 2020" Prescrire Int 2020; 29 (212): 51-1 - 51-10.

Share