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Case ref:201200022
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Date:October 2012
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Body:A Medical Practice in the Lanarkshire NHS Board area
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment; diagnosis
Summary
Mr C suffers from a number of painful conditions. He takes codeine (a pain relief drug) to manage the pain, but it causes severe constipation. He was prescribed Orlistat (a weight-loss drug) by his GP some years ago to help him reduce and maintain a steady weight. Mr C found that the drug also relieved his constipation. When reviewing Mr C's medication, however, his GP felt that it was no longer appropriate to continue to prescribe this. Mr C was referred several months later to a pain clinic for pain management and to explore alternatives to codeine, and to a dietician about his weight problem. However, he continues to suffer from weight gain and constipation and maintains that the benefits of taking Orlistat outweigh the risks of both that medication and the alternatives. He complained to us that the decision to stop prescribing it was unreasonable.
After taking advice from one of our medical advisers, we did not uphold Mr C's complaint. We found that the GP's decision was reasonable as Mr C had not lost weight since early 2009, and the medication is not licensed for use as a laxative. We also found that the decision followed the health board's guidelines on its use.