Articles

In a guideline for the pharmacological treatment, the priority is usually based on the strength of the evidence of efficacy. This is academically correct, but not clinically appropriate. Adverse effects are as important as efficacy in clinical practice. There are guidelines for the pharmacological treatment that take adverse effects into account. However, most adverse effects considered are those obtained in double-blind studies of pharmacological treatment performed to prove efficacy. In the treatment guidelines of various diseases, too little effort is spent on pharmacological adverse effects compared to the effort spent on pharmacological efficacy. I would like to make recommendations in the guidelines for the pharmacological treatment of all diseases. The guidelines for the pharmacological treatment of various diseases should be developed with increased efforts to investigate adverse effects. Some guidelines for the pharmacological treatment use systematic reviews and meta-analyses to examine the efficacy of medicine, and similar methods should be used to examine the adverse effects of medicine. It is easy to prioritize medicines based on evidence of efficacy. However, it is not appropriate to prioritize medicines in clinical practice based solely on evidence of efficacy. Adverse effects should also be considered in priority ranking of medicine in clinical practice. In addition to efficacy and adverse effects, price and the degree of off-label prescribing also affect the priority ranking of medicine in clinical practice.