Prescrire, a non-profit medication safety organization in France, is committed to better patient care. Prescrire provides clear, comprehensive and reliable information on drugs, therapeutic and diagnostic strategies to enable fully-informed decision-making. The organization also provides continuing education to healthcare professionals, mainly physicians, nurses and pharmacists in the primary care sector. The independent organization is non-partisan and fully funded by its subscribers.
"Our aim is to help healthcare providers by providing evidence-based information on products and strategies," says Etienne Schmitt, Head of the Prescrire Programme in France, Éviter l'Évitable ("Preventing the Preventable"), a voluntary medical error reporting programme (including medication errors). "We have created an evidence scale using a risk and benefit approach that advises healthcare professionals on products to avoid where there is not enough assessment. We provide information every time there is a change to products, including the labelling and design of new products."
Prescrire's assessment of the harm-benefit balance of new drugs and indications are based on a rigorous procedure that includes a systematic and reproducible literature search, identification of patient-relevant outcomes, prioritisation of the supporting data based on the strength of evidence, comparison with standard treatments, analysis of both known and potential adverse effects, and a systematic assessment of the packaging and the labelling.
Prescrire publishes a monthly journal in French and an international edition in English 11 times a year, plus a yearly supplement in French devoted to drug interactions. Prescrire also provides an annual list of drugs to avoid, to help healthcare professionals and patients choose high-quality treatments that minimize the risk of adverse effects. The 2016 review examined medications over a six-year period (from 2010 to 2015) and identifies 74 drugs that are more harmful than beneficial in all the indications for which they have been authorised. In most cases, when drug therapy is necessary, other drugs with a better harm-benefit balance are available.
Medication safety issues that are currently top-of-mind in France include over-the-counter (OTC) products, and the confusion between injectables, particularly concentrates and diluted products.
"OTC products are gaining in popularity because they are less expensive," says Etienne Schmitt. "There is a lot of confusion with packaging and product names due to umbrella brands, and people don't understand how to use the products appropriately. Health agencies should advocate for a better design of product labels and more clarity in product names. The current consultation launched by the French Drug agency (ANSM) gives Prescrire an opportunity to speak-up on patient safety."
Working with regulators on how to prevent medication errors, Prescrire is advocating for better drug formulation and increased transparency from drug agencies, to promote safe labelling and international naming of drugs.
Etienne Schmitt says the International Medication Safety Network (IMSN) is a good opportunity to share information amongst members and to get input on their programs. "Working together the IMSN are developing actionable items, providing recommendations and preparing position statements to improve medication safety world-wide. One example is improving the packaging and labelling of vaccines, because vials can be easily confused with other products. Ready to use products, such as prefilled syringes, offer more rigour around the preparation and labelling of vaccines and will contribute to safer care, but are costly and increase the volume storage."