Long-Term'Self-Managed'Immunosuppressive Treatment Resulting in Death due to Fulminant Hepatitis B Medical Malpractice or Patient's Autolesionism?

摘要

The problem of repeat medicine prescriptions for patients on long-term medication has been vigorously debated for many years. In 1996, a pilot UK study showed that 72% of repeat drugs had no evidence of direct authorisation by a doctor over the previous 15 months. Furthermore, cooperation between general/primary-care practitioners, specialists and hospitals is usually minimal. A more recent survey from The Netherlands revealed that 29-75% of all drug items prescribed in ambulatory care are repeat prescriptions, and this phenomenon often occurs without a direct doctor-patient contact, visit, discussion or re-evaluation of medical treatment. While this approach is expected to reduce the workload for the prescriber and is also convenient for the patient him- or herself, it cannot provide appropriate treatment control, and may be responsible for untoward toxicity and drug interactions.