The lost of my trilogy picks up on medicines again.
In the US, not taking medicines correctly is thought to be the fourth leading cause of death – could this be true?
WHO data on mortality captures medicines use in a variety of categories. I ran the data on the categories concerned with medicines-related harm (ICD-10 codes: X40-X44,X60-X64,Y10-Y14,Y45-Y47,Y49-Y51,Y57). It is less than 1% for any European country for the whole population, but breaking it down by age cohorts reveals interesting results that show at different ages, in different EU countries, there are age-related variations in cause of death, rising with age. None, however, emerges as a leading cause of death on its own.
However, medicines use sit within a system of patient care. Therefore, medicines misuse and medication errors may create conditions for a co-morbidity to assert itself. And of course, whether the drugs were toxic for the patient at a particular dose (keep in mind, pills for instance come in standard sizes and may need to be cut in half or so to get an accurate dose for a patient). Working through this data, though, does highlight areas to pay attention to, and in particular countries where there appear to be noteworthy higher risk. I’d like to see better analysis of medication errors.
Once again, before we target the drugs bill as being out of control, let’s get a better understanding of the dynamics of medicines use itself. We may be spending money foolishly or carelessly. What are the incentives in health systems that may actually encourage this sort of professional conduct?
The devil is not just in the detail, but in the data and in clinical practices.
Want to know more?
WHO datasets are here: http://data.euro.who.int/dmdb/