Featured Research

from universities, journals, and other organizations

Patient requests for specific drugs have major impact on prescribing, reports study

Date:
March 14, 2014
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
Patient requests for specific medications -- including requests for brand-name drugs spurred by direct-to-consumer (DTC) advertising -- have a substantial impact on doctors' prescribing decisions, suggests a study. "A patient request for a specific medication dramatically increases the rate at which physician s prescribe that medication," according to the lead researcher. "These results highlight potential negative impacts of DTC advertising and other forms of activation in medication requests."

Patient requests for specific medications -- including requests for brand-name drugs spurred by direct-to-consumer (DTC) advertising -- have a substantial impact on doctors' prescribing decisions, suggests a study in the April issue of Medical Care. The journal ispublished 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 advertising -- familiar to television viewers as "Ask Your Doctor" ads -- for 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 care -- for 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.


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. John B. McKinlay, Felicia Trachtenberg, Lisa D. Marceau, Jeffrey N. Katz, Michael A. Fischer. Effects of Patient Medication Requests on Physician Prescribing Behavior. Medical Care, 2014; 52 (4): 294 DOI: 10.1097/MLR.0000000000000096

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "Patient requests for specific drugs have major impact on prescribing, reports study." ScienceDaily. ScienceDaily, 14 March 2014. <www.sciencedaily.com/releases/2014/03/140314111348.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2014, March 14). Patient requests for specific drugs have major impact on prescribing, reports study. ScienceDaily. Retrieved August 20, 2014 from www.sciencedaily.com/releases/2014/03/140314111348.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "Patient requests for specific drugs have major impact on prescribing, reports study." ScienceDaily. www.sciencedaily.com/releases/2014/03/140314111348.htm (accessed August 20, 2014).

Share This




More Health & Medicine News

Wednesday, August 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola-Hit Sierra Leone's Freetown a City on Edge

Ebola-Hit Sierra Leone's Freetown a City on Edge

AFP (Aug. 19, 2014) Residents of Sierra Leone's capital voice their fears as the Ebola virus sweeps through west Africa. Duration: 00:56 Video provided by AFP
Powered by NewsLook.com
101-Year-Old Working Man Has All The Advice You Need

101-Year-Old Working Man Has All The Advice You Need

Newsy (Aug. 19, 2014) Herman Goldman has worked at the same lighting store for almost 75 years. Find out his secrets to a happy, productive life. Video provided by Newsy
Powered by NewsLook.com
Researcher Testing on-Field Concussion Scanners

Researcher Testing on-Field Concussion Scanners

AP (Aug. 19, 2014) Four Texas high school football programs are trying out an experimental system designed to diagnose concussions on the field. The technology is in response to growing concern over head trauma in America's most watched sport. (Aug. 19) Video provided by AP
Powered by NewsLook.com
American Ebola Patient Apparently Improving, Outbreak Is Not

American Ebola Patient Apparently Improving, Outbreak Is Not

Newsy (Aug. 19, 2014) Nancy Writebol, an American missionary who contracted Ebola, is apparently getting better, according to her husband. The outbreak, however, is not. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins