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Independents' Day

My constant battle to curb food supplements

I read with interest the story on Dr Martin Clark headlined 'GP's demand on food supplement scripts' and would endorse both his views and his call for action.

As the prescribing lead in our practice I am constantly trying to reduce or curtail the use of food supplements. This is also an area of major concern to our PCT's prescribing team which is having to control demands to prescribe those foodstuffs for drug addicts.

For years I have tried to discourage prescribing of formula milk replacement products. Often the children are past weaning age and the milk is being demanded on socioeconomic grounds.

A large amount of supplements in our area is initiated at secondary care level. Recently one elderly patient (not a cancer patient) was discharged on four separate supplements, representing a monthly bill of £800. I consider most of those products are unpalatable to a healthy, let alone a sick, person so it was likely they would end up wasted.

Within the primary care context, major users of these products are residential and nursing home. We have encouraged homes to purchase liquidisers and look carefully at natural supplementation and sensible diets.

Recently, to deal with the problem rationally, as a medicines management practice we initiated a project where deserving residents were seen by dietitians with a view to them receiving professional advice, and then reducing the need for supplements. What was the outcome? On the first visit to one home to see two residents, the home added three more residents. The dietitian put the whole group on supplements costing hundreds of pounds.

It is not a GP's remit to feed patients from gradually diminishing drug budgets. Equally, the lack of Government guidelines does not protect GPs from complaints that may result from refusal to prescribe. The rules on ACBS are too open ended.

Dr Robert Whelan


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