No abstract
on which over the counter drug they had recommended and the reason for the recommendation. Table 1 gives the number and proportion of consultations at which information on prior use of an over the counter drug was elicited and at which a prescription was issued or an over the counter drug was recommended, or both. Over the counter drugs were recommended during 444 consultations, but the actual drug was stated in only 413. The six general practitioners varied considerably in their rates of recommending over the counter drugs (from 2.3% to 37.5%) and issuing prescriptions (from 30.6% to 78.2%). Recommending an over the counter drug seems to be a management option that is used in addition to, rather than instead of, issuing a prescription. Most recommendations (305/413) were for simple analgesics, especially paracetamol preparations (184/413). Medicines that have changed since 1990 from being available only on prescription to being available in pharmacies hardly featured (8/413). The main reason doctors gave for recommending over the counter drugs was that they were cheaper for some patients. Increasing patient autonomy or capacity for self care and potential savings in the practice's prescribing budget did not emerge as major reasons for recommending over the counter drugs.
During the author's tenure (1990-1991) of the British Journal of Surgery Travelling Fellowship of the Association of Surgeons of Great Britain and Ireland, a study was made of surgical training in this country and abroad. This report outlines certain beneficial changes which may be made in UK training programmes.
Randomized study to examine the value of on‐table inspection of the appendix mucosa (Br J Surg 2001; 88: 837–8) Letter 1 P. F. Jones, 7 Park Road, Cults, Aberdeen AB15 9HR, UK Letter 2 Z. Soonawalla,Department of General Surgery, Morriston Hospital, Swansea SA6 6NL, UK Author's reply G. Pettigrew, Department of Surgery, Level E9, Box 202, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK Sentinel node biopsy with technetium‐99m colloidal rhenium sulphide in patients with breast cancer (Br J Surg 2001; 88: 704–7) C. Rogers, Department of Surgery, Rotherham District General Hospital, Rotherham S60 2UD and I. A. F. Azmy, The Royal Hallamshire Hospital, Sheffield S10 2JF, UK Author's reply T. Watanabe, Department of Surgery 2, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960–1295, Japan A single normal ultrasonographic scan at age 65 years rules out significant aneurysm disease for life in men (Br J Surg 2001; 88: 941–4) S. Mehta and I. A. A Hindmarsh, Department of Surgery, Broomfield Hospital, Broomfield, Chelmsford CM1 7ET, UK Author's reply B. P. Heather, Gloucester Vascular Group, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK © 2001 British Journal of Surgery Society Ltd
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