Although it may sound paradoxical, almost all the deadly combinations of drugs are well known: the reactions occurring in their interactions are well understood, documented and can be quite easily accessed to. This information is stored in a variety of medical databases accessible to almost any German or French doctor. But the trouble is that the clinicians rarely use such information services, often simply not aware of their existence. In addition, the German pharmacies sell many drugs sold without a prescription, and if they are applied improperly, they can cause a death of the patient.
According to one of the largest UK databases on medical negligence solicitors, unfortunately, medical errors are more likely to be committed by young doctors, and this is due, primarily, to their lack of a systematic approach to the healing process, the logical transition from one stage of organisation and implementation of treatment to another. The following steps can be listed in chronological order:
- clinical prediction;
- analysis and evaluation of the effectiveness and cost-effectiveness of alternative therapies;
- assessment of the risk of possible side effects and complications of treatment;
- tactical choice of treatment options;
- carrying out treatment activities;
- analysis of intermediate and final results of treatment.
Clinical prediction is a very important stage of the organisation of treatment, where the main objective is an accurate assessment of the possible factors that affect a person’s health status without the intervention of a doctor. This approach allows to establish a causal connection of occurrence of a disease, determine the probability of its occurrence, and predict the future development of the pathology and the likely outcome. Compiling an individual prognosis, the physician should compare it with the known observations in groups of similar patients. When carrying out risk assessment and prognosis is formulated, it is crucial to solve the question: ‘which method of treatment should be selected to provide the desired effect in the shortest possible time with minimum cost to help the patient?’.
The answer to this question can be obtained by reviewing the likely effectiveness and cost-effectiveness of the chosen method of treatment or comparison of alternatives. How to evaluate the effectiveness of a particular treatment? The question is very difficult. Normally, doctors rely on the recommendation of colleagues, data from clinical trials of the method in their own and other hospitals, stats and articles, as well as personal experience. Thus, not so long ago there were dozens of treatment options that produced a breakthrough in the old notions of healing of certain diseases, such as the use of antibiotics in 40-50 years in the treatment of pneumonia.
As for the probability of occurrence of side effects of treatment, the doctor can give estimations and predictions when he is well aware of the selected drug, its pharmacokinetics, pharmacodynamics and therapeutic effect. Co-administration of multiple drugs can change their action, the potential for drug interactions is inexhaustible. Therefore, the number of prescribed drugs should be kept to a minimum: this is a basic rule that to a certain extent guarantees the safety of treatment.