Author Archives: Rupert Payne

Could reducing over-prescribing cause harm?

The lead headline in many media outlets yesterday was how GPs and the 111 system had failed in the sad case of a 1-year old, William, who died of an undiagnosed infection. I was interested to be contacted by a journalist from one paper, who asked me if I had any views on one particular …read more

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Are NICE not being nice to GPs about antibiotics?

The new Antimicrobial Stewardship guidance was published this month by NICE, looking at organisational and system-wide approaches to optimising antimicrobial use. And the main message coming out of various news agencies today is that GPs will be “struck off” for not prescribing antibiotics appropriately. There is, of course, huge concern around the rising amount of …read more

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Drug safety in a world of multimorbidity and polypharmacy

New research describes an association between use of two commonly used medications and brain haemorrhage. CCHSR’s Rupert Payne doesn’t necessarily think it’s that straightforward.

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Don’t incentivise withholding of antibiotics!

Don’t prescribe too many antibiotics. And just to make sure you behave, we’ll pay you not to. That’s the latest message GPs are being given by the government. I personally find this very irritating. GPs are well aware of the public health implications of prescribing too many antibiotics, and the consequent risks of antibiotic resistance. …read more

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Medication errors in primary care in the developing world

Global spending on pharmaceuticals is roughly a $1 trillion, dominated by the US, Japan and major EU economies. Yet emerging markets and the developing world still account for around a third of expenditure. That’s a lot of medicines and it’s growing. With this substantial use of medications comes a significant risk of harm, compounded by …read more

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Medicalising life

Medicines have been getting into the mainstream news quite a lot in recent times. A couple of days ago saw the publication in Annals of Oncology of a review of the evidence for a protective effect of aspirin in reducing cancer in the general population. The role of aspirin in cardiovascular disease prevention is well …read more

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Top Health Policy Think Tank in the World!

Well well well, it’s celebrations here at CCHSR at this momentous achievement…

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A symple lesson?

Hypertension is a huge public health problem, and contributes significantly to the development of cardiovascular disease. The mainstays of treatment are lifestyle measures and a range of common pharmacological agents such as ACE inhibitors, calcium channel blockers and diuretics. The general approach to managing hypertension is, the lower the blood pressure, the better. However, a …read more

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The King’s Fund: Polypharmacy and Medicines Optimisation

Policy, medical training and clinical practice have failed to adapt to a significant increase in the number of patients taking multiple prescription drugs, according to a new report published by The King’s Fund. CCHSR’s Rupert Payne co-authored the report, and discusses its implications.

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Are ACE inhibitors not as ace as we thought?

ACE inhibitors and “sartans” are the NHS’s second most commonly prescribed drugs, used to treat a range of cardiovascular problems. Work by members of CCHSR published in the journal PLOS One shows that their increasing use appears to be strongly associated with acute kidney injury.

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