Salut calls for responsible use of drugs

The Catalan government, through the Department of Health, has called for responsible consumption of certain drugs as part of a campaign it has launched called "Pills, only as many as necessary" to reduce the misuse of certain medications. This information campaign is aimed at all citizens, although it pays special attention to those who take ten or more medications simultaneously every day.

The first action of the campaign focuses on reducing the misuse of antiulcer drugs, which reduce the amount of acid in the stomach and are used to treat various digestive diseases. Drugs belonging to this group include omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole, among others. These drugs are also frequently used in patients without intestinal disease who take them to prevent complications from taking other medications, such as bleeding caused by anti-inflammatory drugs, as well as aspirin or ibuprofen. These are popularly known as gastric protectors.

Catalonia, among the European countries with the highest consumption of antiulcer drugs

Data on antiulcer drug consumption in Catalonia are slightly lower than those in Spain and show a stabilization over the last five years—from 2018 to 2023—at around 120 daily doses per thousand inhabitants (DDI). However, these figures are well above those of other European countries such as France, which has 90 DDI, ahead of Sweden (85 DDI) and Italy (84 DDI). Therefore, continued work is needed to adapt their use.

In 2023, one in six polymedicated and frail patients, who were being treated with a proton pump inhibitor, was taking it for an indication that needed review. Hence the importance of this campaign, which the Government has now launched.

It is important to emphasize that not all people treated with anti-inflammatory drugs need to take these medications, but only people who have associated risk factors, such as those who have had a previous gastrointestinal bleeding, who are over 65 years of age, or who are being treated with other irritating medications.

Proton pump inhibitors are well-tolerated medications if taken for a short time. However, continued use can cause rare but important adverse effects, such as osteoporosis and bone fracture, gastrointestinal and lung infections, kidney inflammation, malabsorption of vitamin B12, and decreased magnesium levels in the blood.

Polypharmacy: a growing problem to be eradicated

Inappropriate polypharmacy refers to situations in which a person incorrectly takes five or more medications, and the risks associated with taking them, such as adverse events, outweigh the expected benefits. Currently, the number of polypharmacy patients receiving ten or more medications simultaneously in Catalonia is approximately more than 315,000, representing 8.9% of users with at least one chronic prescription.

One of the most common patterns of polypharmacy is that of the elderly, with significant comorbidity, in which each disease requires one or more medications. However, it is important to focus on the fragile polypharmacy patient to avoid the serious risks of polypharmacy.

Reducing inappropriate polypharmacy is a Health Department commitment aligned with the UN Global Compact for Sustainable Development (Agenda 2030) and is a strategic line of work integrated into the Department of Health's Chronicity and Frailty Model.

The campaign will also be extended to other medications.

This is the first of several actions within the "Pills, only those necessary" campaign. Later, the focus will be on reducing the inappropriate use of other drugs such as non-insulin antidiabetics, lipid-lowering drugs, urinary antispasmodics, and anticholinergics.

More information at Health Channel.