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Statin renal boost

Rob Finch reports on controversial studies presented at a recent pharmaco-epidemiology conference in Bordeaux

Defence bodies are urging GPs to gain informed consent before prescribing women teratogenic drugs after research revealed 'worryingly' high prescribing rates early in pregnancy.

Teratogenic medication was prescribed to 0.6 per cent of women in the first 70 days of pregnancy and 7 per cent in the three months beforehand, delegates at the recent International Society for Pharmaco-Epidemiology conference heard.

GPs expressed concern at the figures and the Medical Protection Society and Medical Defence Union stressed it was vital the potential risks of medication were made 'absolutely clear' to patients.

Researchers analysed data on 81,975 pregnant women from the UK general practice research database and found 75 per cent took prescribed drugs during the first 70 days, nearly 1 per cent of which had the potential to cause abnormalities.

The authors said the risks posed by these drugs to the

fetus outweighed benefits to the mother.

Dr Gerard Panting, communications and policy director of the MPS, warned a fifth of complaints dealt with by his organisation resulted from prescribing errors.

But he said GPs were in a difficult position because prescribing had become more complex and women of childbearing age often needed medicines that had the potential to be damaging.

Dr Panting added: 'You need a high index of suspicion in women of that age. You have to make sure the drugs are the least potentially damaging and make it absolutely clear to the patient what the risks of the medication are. That's an informed consent issue.'

Dr Mayur Lakhani, RCGP spokesperson on clinical governance and a GP in Sileby, Leicestershire, said: 'I'm concerned to find these drugs were prescribed at the level they were. But I am pleased to see that the majority of prescribing was safe. Most GPs take this very seriously and the profession has learnt lessons from thalidomide.'

Dr Lakhani warned of the need for 'constant vigilance'. He said: 'Generally we need more information at our fingertips about these issues – we haven't got that fully cracked yet.'

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