Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2008
[Medical problems and risks of switching drugs according to legal requirements of drug discount contracts in Germany].
Since 2007 German health insurance funds may conclude discount contracts with pharmaceutical companies for individual drugs. According to German legislation pharmacies are liable to preferentially dispense these drugs to patients of the respective funds if the prescribed drug is identical regarding active ingredient, strength, package size, and route of administration, and is approved for the same indication. We aimed to assess the number and nature of clinically relevant differences between prescribed drug and its legal alternatives. ⋯ This study has revealed that current legal provision ignore important medical criteria of the substitution process including individual risks (e. g. allergies). Patients will have to change the drug application process and will therefore need appropriate information and training. All these differences between substitutional drug pairs should already be known when prescribing so as to maintain patient safety in the face of this merely cost-saving measure.
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Dtsch. Med. Wochenschr. · Jun 2008
Review[Influence of opioids on the psychomotor ability of patients in chronic pain].
Studies have provided no evidence that effective and stable long-term opioid treatment of pain necessarily impairs psychomotor abilities. Assessment of psychomotor abilities, especially of those involved in driving, can only be made in the individual case. Such abilities are affected especially by drug combination and such individual factors as age and driving experience.
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Dtsch. Med. Wochenschr. · Jun 2008
Review[Driving ability under opioids: current assessment of published studies].
Opioids are more frequently used in the treatment of chronic non-cancer pain. The aim is not only to reduce pain intensity, but also the patients' reintegration into their social environment, including the possibility of driving their own car. Various studies have investigated the impact of opioids on driving ability. ⋯ These results indicate that stable opioid treatment does not necessarily impair driving ability of patients in chronic pain. However, so far published studies do not provide clear evidence for saying that persons on sustained opioid treatment can drive a car without any problem. Nor do they indicate that such persons should not drive.