Navigation Links
Patient requests for specific drugs have major impact on prescribing, reports study in Medical Care
Date:3/14/2014

Philadelphia, Pa. (March 14, 2014) Patient requests for specific medicationsincluding requests for brand-name drugs spurred by direct-to-consumer (DTC) advertisinghave a substantial impact on doctors' prescribing decisions, suggests a study in the April issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"A patient request for a specific medication dramatically increases the rate at which physician s prescribe that medication," according to the new research led by John B. McKinlay, PhD, of New England Research Institutes, Watertown, Mass. They add, "These results highlight potential negative impacts of DTC advertising and other forms of activation in medication requests."

How Do Doctors Respond When Patients Request Specific Drugs?

The researchers designed an experimental study to evaluate the effects of "activated" patient requests for specific medications. They made videos in which professional actors portrayed patients with two common, painful conditions: sciatica causing back and leg pain or osteoatrthritis causing knee pain.

Half of the "patients" with sciatica specifically requested oxycodone, a strong narcotic painkiller; while half of the patients with knee arthritis requested the prescription drug Celebrex. The other half of patients requested "just something to make it better."

The patients requesting oxycodone said they had tried their spouse's leftover medication; those requesting Celebrex said they saw it advertised, and that a co-worker took it and said it really helped. The video scenarios were randomly shown to 192 primary care physicians, who were then asked a series of questions about diagnosis and management, including what treatment they would recommend.

The results suggested that "activated" patient requests for drugs had a strong effect on recommended treatments. About 20 percent of sciatica patients requesting oxycodone would receive it, compared to one percent of those making no specific request. Strong narcotic pain relievers such as oxycodone are generally not recommended for sciatica, particularly for a newly presenting case, such as was in these cases.

About half of knee arthritis patients requesting Celebrex would receive that drug, compared to one-fourth of those requesting no specific medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Celebrex are recommended for treatment of knee arthritis. However, the brand-name drug Celebrex is a "selective" NSAID that is much more expensive than other options, with no additional benefit. The gender, race/ethnicity or socioeconomic status of the patient had no effect on the inclination to grant a patients' request.

Results Raise Questions about Impact of DTC Advertising

Even if they didn't receive the specific drug they requested, treatment patterns differed for patients who made active requests. "Patients requesting oxycodone were more likely to receive a strong narcotic and less likely to receive a weak narcotic," according to Dr McKinlay and colleagues. "Patients requesting Celebrex were much less likely to receive a non-selective NSAID."

The findings add to concerns over the potential safety and economic impact of prescription drug requests driven by DTC advertising. The United States is one of only two countries that permit DTC advertisingfamiliar to television viewers as "Ask Your Doctor" adsfor prescription drugs.

There is continued debate over the impact of DTC advertising. "Supporters defend the practice as a way to empower consumers, while opponents argue that commercially motivated messages leads to inappropriate patient requests for medication," comments Dr G. Caleb Alexander, Deputy Editor of Medical Care. "In order to resolve this debate, more research is needed to determine the effects of DTC advertising on patient and physician behavior, especially how it affects prescribing decisions and health outcomes."

The new report is one of the few rigorous experimental studies to evaluate the impact of DTC advertising. Since DTC advertising is exclusively used for expensive medications, patient requests for specific medications "activated" by ads are likely to increase medication costs.

In addition, some activated requests may sometimes lead to suboptimal carefor example, patients receiving oxycodone for sciatica or Celebrex for arthritis might have more side effects, compared to alternative medications. "The results highlight the ongoing need for improving strategies for patient-physician communication," Dr McKinlay and coauthors conclude.


'/>"/>

Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. Higher-spending hospitals have fewer deaths for emergency patients
2. Researchers uncover a viable way for colorectal cancer patients to overcome drug resistance
3. Vaccine yielded encouraging long-term survival rates in certain patients with NSCLC
4. Study finds doctors have exaggerated fears when starting patients on insulin
5. Diagnostic Scans Tied to Radiation Risk for Gastro Patients
6. Predictors identified for rehospitalization among post-acute stroke patients
7. Pulse pressure elevation could presage cerebrovascular disease in Alzheimers patients
8. Breast cancer patients suffer treatment-related side effects long after completing care
9. Heart failure patients with diabetes may benefit from higher glucose levels
10. Gastro Woes Often Strike Rheumatoid Arthritis Patients
11. Short Walks May Ease Fatigue in Pancreatic Cancer Patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... Today, the ... , announced that the much-anticipated feature with author Jahnavi Foster, specialist in healthy vegetarian ... TV Network. , Each week, on his weekly Whole-Food Warrior TV show, Frank Davis ...
(Date:2/5/2016)... ... February 05, 2016 , ... ... addition of micro-needling services in their Napa Valley office. The technique utilizes the ... Surgery Associates, Dr. Canales and Dr. Furnas, are part of only a select ...
(Date:2/5/2016)... Florida (PRWEB) , ... February 05, 2016 , ... ... non-profit organization devoted exclusively to funding innovative lymphoma research and serving the lymphoma ... – is poised to once again host, Swirl, A Wine Tasting Event at ...
(Date:2/5/2016)... ... 05, 2016 , ... Regular gym users know the routine: each January, they ... access the treadmills. It’s a predictable trend. After the excesses of November and December, ... shape by joining gyms, starting new walking or running routines, or signing up for ...
(Date:2/5/2016)... , ... February 05, 2016 , ... At its annual ... Patrick McDermott as Chairman of the National Board of Directors. Mr. McDermott succeeds former ... the Board,” stated Leslie A. Chambers , APDA President and CEO. “Pat has ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... India , February 5, 2016 ... a new market research report "Fetal (Labor & Delivery) ... & Antepartum), Warmer, Incubator, Pulse Oximeter, Phototherapy/Jaundice Management Devices, ... published by MarketsandMarkets, This report studies the global market ... market is estimated at USD 6.28 Billion in 2015 ...
(Date:2/4/2016)... 2016 For hospitals considering enrollment in the ... in the program, the Health Resources and Services Administration,s ... , Mega-Guidance , could have significant impact on plans ... September 2016. Essential Insights , Daniel ... summarizes the Mega-Guidance,s key proposed changes, including a new ...
(Date:2/4/2016)... , Feb. 4, 2016  SciClone Pharmaceuticals, ... announced it has entered into a settlement agreement ... (SEC) fully resolving the SEC,s investigation into possible ... Under the terms of the settlement agreement, SciClone ... million, including disgorgement, pre-judgment interest and a penalty.  ...
Breaking Medicine Technology: