One in 3 elderly people takes 10 drugs a day (not all of them useful) and hospitalisations are booming

A website, an app and a newsletter, scientific publications on drugs 'translated' for the general public and to guide doctors through the labyrinth of interactions between different medicines. These are the tools with which the Italian Medicines Agency, together with the regions, is committed to 'breaking the industry monopoly on drug information' and which form the basis of the 'COSÌsiFA' project.

Among the issues addressed was polypharmacotherapy, i.e. the phenomenon of too many drugs prescribed to the elderly, given that today one in three takes ten or more a day. Moreover, too many medicines are also bad not only because of interactions, but also because of adverse reactions that are the cause of almost one in ten hospitalisations.

The Aifa's independent drug information project, for which there are five million available for three years, aims in essence to disseminate news, information, studies and data widely. Without neglecting training, starting with training in schools. Breaking the pharmaceutical industry's monopoly on drug information has, Aifa explains, 'a twofold objective: to convey to health professionals scientific information that is essential for their best use, and to lead citizens towards a more appropriate use of medicines'. Independent information will be provided through seven channels: an independent information website (www.infarmaco.it); a six-monthly bulletin; the production of news and newsletters that make the scientific literature available to the general public; reviews of studies already published; training events, including in schools; communication through social networks; and an app for rapid and customised information.

Four thematic areas are at the centre of the project, which is intended to act as a compass for citizens and doctors: paediatrics, oncology, antibiotic resistance (with 11,000 deaths a year caused by resistant bacterial infections, Italy is the black jersey in Europe), chronicity, and polypharmacotherapy, a problem that is increasingly felt in the elderly population struggling with the difficult interaction of taking 10 or more drugs a day. In Italy, in fact, too many drugs are consumed, 'but there is also a tendency to prescribe too many. Moreover, too many drugs are also bad for the risk of interactions. Sometimes it is better to take one less drug than one more. Especially in fragile or chronic individuals, for example the elderly, who are the biggest consumers of drugs," emphasises President of the Italian Medicines Agency, Robert Nisticò. "This network for independent pharmaceutical information has all the potential to solve the major criticalities we find today in drug communication," added Aifa's technical-scientific director, Pierluigi Russo.

Misuse of drugs, on the other hand, can have very serious consequences: '8-9% of hospital admissions, according to recent international studies, are due to adverse drug reactions. Medicines save millions of lives, but they also have risk profiles. The message is, therefore, do not take drugs you do not need, with attention also paid to supplements and herbal medicines,' explained Ugo Moretti, Professor of Pharmacology at the University of Verona. Until a few years ago, he added, 'the estimate of admissions for adverse reactions was 4-5% of the total, but at 8-9% it has risen with the increase in drug intake'. In the 1990s the figure showing drug-taking as the fourth leading cause of death caused a stir, 'but it is not unexpected', he explained.