More doctors moving towards adjunctive therapy

More doctors are moving towards adjunctive therapy - using more than one drug or treatment to treat an illness - as the ageing population in Singapore begins to suffer from more chronic diseases.

By Sara Grosse- 20 Feb 2015

SINGAPORE: Researchers said there has been a rapid increase in the use of adjunctive therapy as Singapore faces an ageing population who suffer from several chronic diseases. Adjunctive therapy refers to using more than one drug or treatment to treat an illness.

Last year, a team of researchers discovered that they could successfully fight respiratory diseases like pneumonia by combining several drugs. The team developed a drug formulation comprising several antibiotics and an agent that acts against mucus to kill bacteria in the lungs.

It was found that this combination, which is inhaled, is more convenient and effective than individual treatments.

Dr Desmond Heng, a scientist with the Institute of Chemical and Engineering Sciences, said: "Our combination consists of existing drugs not commonly given via the inhalation route as well as old drugs that were previously abandoned due to toxic side effects or were facing resistance when applied in monotherapy."

Similarly, an old anti-diabetic drug was also recently discovered to boost the efficacy of tuberculosis treatment without causing drug resistance.

Researchers said these adjunctive therapies are becoming more common as patients with multiple chronic conditions usually have to consume several medications. There are also more drugs on the market to choose from.

While the effects may be more successful than a singular treatment, researchers such as Professor Ranga Krishnan warn against over-treating. Prof Krishnan, who is the dean of the Duke-NUS Graduate Medical School in Singapore, said: "As people get older, they have many medical problems and before you know it, they take a bagful of medicines. So you need to always keep an eye on it so you don't overdo it. Always try to replace one with another rather than keep on throwing more.

"For the elderly, it is a problem because many older individuals are taking three to six different drugs. It is not only cost. Sometimes, they cannot remember when to take the different drugs."

Combination therapy - when more than one drug is combined into a pill - is one way around this. Also considered a type of adjunctive therapy, combination therapy has been used to treat conditions such as AIDS, cancer and high blood pressure. Because the medication is in a singular form, there is a higher likelihood of patient compliance.

However, there are risks associated with combination therapy. Researchers said that certain drug combinations may end up having more side effects for patients. At the same time, certain drugs may end up countering each other when mixed together. So researchers have to take these dangers into account before embarking on combination therapy. 

- CNA/ac