Fragmented care means patients can be put on drugs by many different specialists, says Charles Warlow, while Dr Wendy Outwin highlights the daily reality of prescribing medicines

Ministers seem to have found yet another way to bash overburdened GPs (Government review finds 10% of drugs dispensed in England are pointless, 22 September). There is nothing new about overprescribing and the inevitable polypharmacy, which the pharmaceutical industry is not exactly eager to discourage. It has been a problem for decades. But the causes are mostly nothing to do with the GPs themselves.

At medical school it was drummed into us when to prescribe drugs (the “indications”) and when not to (the “contraindications”), but seldom if ever when to stop them (except for side-effects). Patients can be discharged from hospital on all sorts of drugs, but often neither the patient nor the GP are given any indication about how long they should be taken for.

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