Jump to comment:
- Page navigation anchor for Gluten-free food prescriptions for children with coeliac disease: should families have to pay?Gluten-free food prescriptions for children with coeliac disease: should families have to pay?The Department of Health is consulting (until 22nd June)1 on withdrawing gluten-free food (GFF) prescriptions for patients with coeliac disease (CD), aiming to save £25million. Many CCGs have already stopped or restricted prescribing, stating that families should buy their own GFF instead.
CD affects 1% of the population, putting them at risk of long-term consequences (including subfertility, osteoporosis, lymphoma and poor growth), and the only treatment is a strict GF diet. Children are entitled to free NHS prescriptions, and dietary staples (bread, flour, pasta) have been available within regulated limits since the 1960's.2 Since ’gluten intolerance’ (functional symptoms exacerbated by gluten intake) emerged in the 1980’s, GFF is more evident in supermarkets but remains costly. Availability is poor in convenience and budget stores where low-income families and those without transport shop more frequently.3 One patient questionnaire found that 28% struggled to locate stores with GFF, and 27% reported difficulties identifying GFF.4
In some CCG consultations, low-quality information reflects press reports claiming “thousands of prescriptions... for custard creams, doughnuts and pizzas”. Anything that prejudices adherence to a strict GF-diet has negative implications for long-term health and NHS resources, and NICE recommends access to GFF prescriptions.5 Natur...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Do no harm - a serious concernDo no harm - a serious concernMy concern is about what I think I am seeing happening around an apparent strong connection between ever rising prescribed medications (as a psychotherapist I have been looking particularly at antidepressants and other medicines prescribed for anxiety, insomnia etc.) and patients finding themselves with a 'working diagnosis' of 'medically unexplained symptoms' or somatic system disorders and treated as such.I would like to draw particular attention to the work of Fava and Carvalho et al:The wide-ranging multi-system side-effects, tolerance and withdrawal problems that have been seen with these commonly prescribed antidepressants (used both on- and off-label) - and which I hear many individual experiences of - seem to bear a startlingly close resemblance to the common 'medically unexplained symptoms'. I have been particularly alarmed to learn that the widely-used PHQ-9 and GAD-7 are used in conjunction with PHQ-15 to help in the 'diagnosis' of Medically Unexplained Symptoms - and that these questionnaires were developed in conjunction with Pfizer.We certainly need to be seriously exploring what physiological and psychological ha...Show MoreCompeting Interests: None declared.