Sir, – Your editorial “Ethical dilemma of scarce drugs” (June 6th) highlights the difficulties associated with the shortage of one specific medication. A systematic approach to medication shortages and the promotion of rational drug prescribing requires careful consideration. There has been a 50 per cent increase in prescribed medicines since 2004 and a considerable amount of this relates to the increase the older population with complex care needs. It has been estimated that 16 per cent of all acute medical admissions to hospital are, in fact, medication related.
Despite the ever-increasing complexity associated with drug utilisation, potential for adverse effects and ever-increasing drug costs, there is no adequate IT infrastructure to support appropriate drug use in the country. Indeed, some medical schools don’t even have departments of clinical pharmacology and therapeutics. The Royal College of Physicians in Ireland, which is responsible for higher specialist training, was unable to recruit a single trainee into the specialty of clinical pharmacology (the medical specialty for drugs) this year.
A coordinated and systematic approach that underpins the rational and safe utilisation of the more than 1,500 medicines available in this country is urgently required rather than repeated and often emotive responses to the lack of availability of individual drugs. – Yours, etc,
Prof DECLAN LYONS,
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Consultant Physician,
University Hospital
Limerick.