E-DRUG: Need for cough mixtures (contd.)
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Excerpts from Joel Lexchin's message:
There is a lot of literature around showing that patients with upper
respiratory infections don't necessarily want a prescription, what
they want, and are satisfied with, is better communication........
Of course, this is not universal, but it suggests to me that the > > > real issue is educating health care workers:
Joel,
This may be true, but the reality is different. In particular in South
Africa and also in Namibia many State Patient (eg the non paying
patient coming to the state facilities) and their doctors do not speak
the same languages. Therefore patient education is to be done by
Primary Health Care staff, eg the nurses. They are however afraid
that the patients will not believe them and there is community pressure.
1) not to prescribe because they feel that patients expect a
prescription
In Namibia patients are entitled to reasonable health care, not to
prescriptions.
2) to communicate better with their patients. This is not an
easy task but is probably the best long-term solution.
Ideal, but impractical.
In the meantime should we have a placebo agent? ....... If we are
going to use a placebo then I would suggest perhaps
dextromethorphan.
No, I disagree. Patients should not get anything unless they need
it.
AND, who is going to pay for this? Budgets are becoming smaller these
days, so why should we spend money that we don't have for drugs that
don't work?
I realize that pressure in private practice is high (so high that 3rd
generation cephalosporins are prescribed for the most banal virus
infections (!).
But this is not the place in State Practice. Here we can do it by the
book.
el
--
Dr. Eberhard W. Lisse\ / Swakopmund State Hospital
<el@lisse.NA> * | Resident Medical Officer
Private Bag 5004 \ / +264 81 124 6733 (cell) 64 461005(h) 461004(f)
Swakopmund, Namibia ;____/
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