Free special edition 2023

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Towards better patient care: drugs to avoid in 2023

● Tomake it easier to choose high-quality care, and to prevent disproportionate harm to patients, Prescrire has published its annual update of drugs to avoid. ● Prescrire’s assessment of a drug’s harm-­ benefit balance in a given situation is under pinned by a rigorous procedure based on: a systematic and reproducible literature search; data on patient-relevant outcomes; prioritisa tion of the highest-level evidence; comparison with standard treatment (if one exists); and appraisal of the drug’s adverse effects, taking into account any uncertainties and gaps in our knowledge. ● Our 2023 reviewof drugs to avoid covers all the drugs examined by Prescrire between 2010 and 2022 that are authorised in the Euro peanUnion or in France. It consists of 107 drugs that aremore harmful than beneficial in all their approved indications.

● Inmost situations,whendrugtherapyappears tobe the best course of action, otherdrugswith a better harm-benefit balance are available. And in some situations, themost prudent option is to forgo drug therapy. ● When seriously ill patients have exhausted all other treatment options, there is no justifi cation for exposing them to drugs with severe adverse effects but no proven efficacy. It is sometimes acceptable to test these drugs in clinical trials, provided that patients are made fully aware of the uncertainties surrounding the drug’s harm-benefit balance, aswell as the trial’s objectives, through discussions tailored to the patient’s level of understanding. For patients who choose not to take part in a clinical trial, appropriate support and symptomatic care are called for, to help themcopewith the absence of any effective treatment optionswhich could improve their prognosis or quality of life

Excerpt from Prescrire Int February 2023 Full article (11 pages) freely available at english.prescrire.org

The original article is freely available online at english.prescrire.org via the Search function, with the keywords “drugs to avoid”

Prescrire International Special Edition 2023 • Page 13