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In the case of painkillers, attention should be paid to possible interactions with other medications

Photo: Peter Dazeley / Getty Images

According to a health insurance study, patients are often exposed to risks that could actually be avoided when treated with painkillers. In the wrong combination, the drugs could, for example, cause dangerous interactions, according to the current Barmer drug report. In addition, certain painkillers should not be used for certain diseases.

For the report, the health insurance company had the data of Barmer insured persons aged 18 and over analyzed, who were treated on an outpatient basis, did not suffer from a tumor disease and were prescribed a painkiller by their doctor.

According to the results, in many cases pain therapy does not comply with medical guidelines – i.e. scientific recommendations for the treatment of a disease.

Dangerous combination: ibuprofen despite heart failure

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For example, some insured persons were prescribed painkillers such as ibuprofen or diclofenac even though they suffered from heart failure. The medical guidelines advise against it, as even a short use of these drugs can worsen the performance of the heart. Instead, the affected persons should be given other painkillers.

The same applies to people with renal insufficiency, i.e. a kidney that is not working properly. Here, drugs such as ibuprofen or diclofenac increase the risk of acute kidney failure.

According to the report, there are also errors in therapy with opioids, i.e. very strong painkillers such as morphine. In 2021, just under six percent of Barmer policyholders without tumor disease were prescribed such an opioid.

Actually, according to the guidelines, those affected should receive a laxative at the same time. According to the results, this was not the case for three out of ten insured persons. This increases the risk of intestinal obstruction fivefold. Five out of 10,000 patients on opioid therapy have to be treated in hospital each year for this complication.

Digitization for a better overview

In addition, opioids should generally not be used together with sedatives, so-called tranquilizers, because the risk of serious side effects, including increased deaths, increases. Nevertheless, around one in ten Barmer policyholders received a sedative at the same time as an opioid prescription. Here, patients would be avoidably endangered, explains study author Daniel Grandt from the Saarbrücken Hospital.

Barmer boss Christoph Straub calls for the mandatory use of digital tools in order to keep track of all given drugs and all side effects and interactions. The therapy, which is usually prescribed by several doctors, is hardly manageable without digital support, he says. "Especially the combination of supposedly harmless painkillers can have fatal consequences."