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

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

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