International Update

EU authorisation for rimonabant suspended

Doctors have been told not to issue any more prescriptions for rimonabant, and to conduct a review of all patients who are currently taking it

The European Medicines Agency (EMA) has suspended the marketing authorisation for diet adjunct rimonabant (Acomplia) across the EU, following concerns about its psychiatric safety. The EMA conducted a study which found that patients taking rimonabant were almost twice as likely to develop psychiatric disorders such as depression, anxiety, sleep disturbances and aggression, compared to patients taking a placebo drug.

Doctors have been told not to issue any more prescriptions for rimonabant, and to conduct a review of all patients who are currently taking it. The review concluded that there was no evidence to prove that the drug reduces the risk of mortality in obese patients, and added that it is safe for patients to stop taking the medication part-way through a course of treatment.

The EMA rejected the option of issuing limitations on rimonabant, saying that restrictions would not reduce the risk of depression to an acceptable level. The drug has been authorised for use in the EU since June 2006.

More information: www.emea.europa.eu

WMA reaffirms importance of clinical independence

The World Medical Association (WMA) has issued a declaration stating that restraints on doctors’ clinical independence can compromise patients’ trust in their doctor. The declaration on professional autonomy and clinical independence says doctors should be able to exercise their professional judgment in the care and treatment of their patients, without facing unreasonable restraint from the government or external medical associations.

More information: www.wma.net/e/press/2008_15.htm

Financial crisis and doctors’ workload

The WMA has warned that health authorities could shift tasks away from doctors to other health professionals to cut costs. Doctors have been told to expect unwelcome changes in the way they work. The WMA predicts that tasks such as prescribing drugs, as well as diagnosing, treating and following-up patients, could soon be the remit of other health professionals who cost less to employ and wish to expand their range of skills.

There have already been many objections raised about the proposal, both by doctors and patients. The WMA suggests that to avoid these cutbacks, doctors should make efforts to organise their services better to prove they don’t need to delegate so much of their workload to nurses or pharmacists. The WMA will be meeting again in March to reassess human resources for health, task shifting and interprofessional relations.

More information: www.wma.net/e/press/2008_10.htm

Oncology training not consistent across Europe

A survey by the European Society for Medical Oncology (ESMO) has revealed that the standard of training for cancer specialists varies widely across Europe. The report shows that oncologists in Ireland and France are required to keep on top of new scientific and medical developments, to ensure their expertise is always up to date.

However, specialists in Spain and Germany are not required to maintain the same level of continuous medical education. This inconsistency is thought to have significant effects on the standards of care cancer patients in Europe can expect to receive. The survey also reveals that any patients who require a second opinion will have their costs reimbursed in the Netherlands and Denmark, but not in Hungary or Luxembourg.

More information: www.bmj.com

Italian surgeons told to specialise

Italy must develop more specialised surgical units to reduce death rates, surgeons have been told. Surgeons at the national congress of the Italian Society of Surgery have heard that many surgical teams carry out major procedures that they are not best qualified to do, resulting in high death rates.

The congress heard that if surgical units were developed to specialise in different areas, patients could be treated in a centre with experience directly relevant to their condition, and surgeons would be more likely to have a higher success rate. One of the main problems identified was that many hospitals had three or four surgical units performing the same procedures, often with varying degrees of success.

By duplicating procedures in this way, hospitals are missing an opportunity to develop expertise and boost success rates, the congress heard.

More information: www.bmj.com

US doctors told to be vigilant about patient privacy

The American Health Information Management Association (AHIMA) has reissued recommendations to educate medical professionals about the importance of patient confidentiality, privacy and data security. The AHIMA’s House of Delegates has recently voted in favour of educating all healthcare workers in America about how to securely audit and monitor access to medical records.

The recommendations have been made to serve patients’ rights to accurate and confidential personal health information, and the need for advanced practices, processes and standards which safeguard their medical records.

More information: www.medicalnewstoday.com