Beyond single and dual diagnosis in general practice: Patients who do  not comply with polypharmacy may be safer

doi:10.1136/bmj.326.7399.1145-a

BMJ 2003;326:1145 (24 May), doi:10.1136/bmj.326.7399.1145-a

Letter

Beyond single and dual diagnosis in general practice

Patients who do not comply with polypharmacy may be safer

The first 100% of the full text of this article appears below.

EDITOR—I concur with Wright et al's unease about polypharmacy.¹ Consultants with narrower interests simply bolt on their particularcare package if the patient is referred in their direction.

Dare I suggest that general practitioners are specialists in "multiple morbidity," which may often include persistent unexplainedphysical symptoms and some degree of somatisation. Could itbe incumbent on us as general practitioners to edit the Leviathanof the modern prescription without recourse to our bewilderedhospital colleagues?

Are we ready to admit that the dangers of polypharmacy usuallyoutweigh the small absolute benefits of each drug? Half ourpatients will not manage to comply in any case. Perhaps theyare the safer.

David J Young, general practitioner principal

Derby DE2 7RJ David.J.Young@btinternet.com

Competing interests: None declared.

Wright N, Smeeth L, Heath I. Moving beyond single and dual diagnosis in general practice. BMJ 2003;326: 512-4. (8 March.)[Free Full Text]

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Moving beyond single and dual diagnosis in general practice: Nat Wright, Liam Smeeth, and Iona Heath
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