Prescription frequency, iatrogenesis and economic evaluation.

Iatrogenesis is classified into two broad types: direct and indirect. By indirect iatrogenesis is meant the accidental or deliberate misuse of prescribed medication. Deliberate indirect iatrogenesis is explored through an analysis of deliberate non-fatal self-poisoning. A statistically significant relationship, previously found, between deliberate non-fatal self-poisoning and the frequency of prescription of psychotropics is used to evaluate the economic consequences of self-poisoning to the hospital sector. In the decision to use or not to use a particular drug, the importance of risk-benefit analysis is stressed. This analysis is used to distinguish between a drug's safety and efficacy. In general, no one criterion should be used to choose between alternative drugs. Finally, some policy implications of the analysis for psychotropic prescriptions are considered.