General practitioners fail in their efforts to prescribe better medication in the final phase of life

In 2017, researchers within the LeVePZ collaboration project concluded that it was desirable for general practitioners to improve their prescribing behavior for people in the final phase of life. New figures show that this is hardly possible, writes NIVEL: “The prescribing behavior of general practitioners in 2021 hardly differs from that of 2017 on three of the four indicators mentioned.”

Laxatives

One indicator that the researchers look at is whether people who are prescribed opioids are also given standard laxatives. This is to prevent constipation – a common side effect. “We see no improvement in this in 2021,” the researchers conclude. “Improvement in this area is therefore desirable.”

Undesirable repeat prescriptions

Between 2017 and 2021, it was hardly possible to reduce the number of undesirable repeat prescriptions. This includes medications that were previously useful but may be inappropriate in the final phase of life, such as Vitamin D, calcium supplements and cholesterol lowering agents. Medication that may no longer be clinically valuable in the final phase of life also falls into this category. Examples include certain heart medications and antacids.

Less opioids

There are indications that GPs do pay attention to the problem, but that it simply does not work. In both cases the percentages decrease by only two percentage points. There has been a substantial decrease in the number of people with a prescription for opioids for pain relief. The researchers cannot say whether this is a sign of good care or not. “Decrease in opioid prescribing does not mean much without knowing context,” they write.