Chief Executive Officer, St Andrew's Healthcare, Northampton, UK.
Ther Adv Psychopharmacol. 2013 Aug;3(4):233-43. doi: 10.1177/2045125312472530.
The growing worldwide use of pharmaceuticals is managed in some countries by a regulatory system which sharply divides legal use into licensed and unlicensed categories. We examine how for the range of psychotropics this simultaneously restricts the possible benefits to patients, prescribers and producers in some domains, while failing to manage the risks in others. A more flexible system, which shares at an earlier stage experience and evidence on benefits and risks in patients, previously marginalized on the grounds of age, diagnosis or comorbidity, would aid the development of safer, more effective 'real-world prescribing'. Practical recommendations are made for a new model of research and prescribing governance, to enable more effective repurposing of these treatments.
全球范围内，医药的使用日益广泛，一些国家通过监管体系来管理，该体系将合法用途严格划分为许可和非许可类别。我们研究了在精神药物这一范畴内，这种划分在某些领域限制了患者、处方者和生产者的获益可能，而在其他领域却未能管控风险。一个更为灵活的体系，可以更早地在患者中分享获益和风险的经验和证据，此前因年龄、诊断或合并症而被边缘化的患者也可以从中获益，从而有助于开发更安全、更有效的“真实世界”处方。我们提出了新的研究和处方管理模式的实用建议，以实现这些治疗方法的更有效再利用。
