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A new prescription for the nation's health?

With experts warning about increasing resistance to antibiotics and over-reliance on prescription drugs, is it time to take a more holistic approach to healthcare?

According to NHS England, 2.7 million prescription items were dispensed per day in 2012. That's a staggering 1,900 per minute. Perhaps more worrying is the fact that this was a 4% increase on the previous year and a whopping 62% more than in 2002.

Not surprisingly, these figures worry many health professionals. Medical scientists have been warning for some time about the over-use of antibiotics and in August last year the National Institute for Clinical Excellence (NICE) published new guidelines to discourage doctors from prescribing them for minor conditions. A recent report in The Lancet has taken the debate to a new level, highlighting research in China that showed resistance to colistin (the 'antibiotic of last resort') in 20% of animals tested, 15% of raw meat samples and 16 patients.

The solution is not simply to stop over-prescribing, but also to take a more holistic approach to healthcare. That means promoting healthy lifestyles and offering alternative therapies which can reduce or eliminate reliance on drugs. NHS England's Live Well web resource has a wealth of information on 'healthy living for everyone', including weight loss, alcohol consumption, stress and anger management, and giving up smoking.

Allied health professionals such as physiotherapists, occupational therapists and dietitians also have a vital role to play. For example, physiotherapy has been proven to improve quality of life and help promote self-management for people with chronic pain, which costs over £500 million per year in prescriptions. Leading dementia specialists have said that a healthier, more Mediterranean-style diet including fish, fresh fruit, nuts and olive oil could have much more impact than drugs. And sleep experts say that non-drug treatments such as cognitive behavioural therapy (CBT) offer the best long-term solutions to chronic insomnia, rather than the 10 million prescriptions for sleeping pills which are written each year.

Mental health strategies

In the mental health sector, non-pharmacological interventions such as talking therapies have significantly reduced reliance on antidepressants. In addition, exercise has long been advocated as an effective alternative to long-term use of drugs such as Prozac and Seroxat. In a 2005 survey of physiotherapists specialising in mental healthcare, 57% said that physical activity was the best form of treatment for mild to moderate depression.

In July 2015 NHS England promised a 'rapid and sustained' action to tackle over-prescribing of psychotropic drugs to people with learning disabilities. This followed the publication of a report by the Care Quality Commission (CQC) and Public Health England which said that there was a much higher rate of prescribing of medicines associated with mental illness amongst people with learning disabilities than the general population.

With health costs rising, there have been calls for more support to enable people to take more responsibility for their own health, reducing the strain on doctors and nurses. In a recent article for The Independent, health writer Jeremy Laurance discussed the issue of involving patients more deeply in their own care. He wrote, "Evidence shows that, when patients share in making clinical decisions and are encouraged to manage their own conditions and look after themselves, not only does their health improve but they also make less use of health services."

In the Health Survey for England 2013, 43% of men and 50% of women reported that they had taken at least one prescribed medicine in the last week. With the total net cost of prescriptions dispensed in a year topping £8 billion, reducing reliance on drugs could not only help our nation's wellbeing, it could improve the health of our finances too.
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