Doctors prescribe drugs to make us feel better, to reduce our risk from chronic illnesses like high blood pressure or heart disease, and, often, because we ask them to.
It's estimated that about half of Americans take at least one prescription drug each year. And a recent online survey done for GlaxoSmithKline found that more than half of people taking a medication have stopped or wanted to stop taking it due to a side effect. Thirty-one percent said they had stopped.
Yet some recent research suggests doctors may be largely in the dark about the harmful effects of many medicines they prescribe.
One international study, published in April in the Journal of General Internal Medicine, found that most family docs are told little about possible harmful side effects from drugs during meetings with drug company representatives.
The study of 255 physicians practicing in Canada, France and the U.S. had the doctors fill out questionnaires about each medicine discussed during a sales meeting. Results showed that in 59 percent of the promotional stops the sales reps did not provide any information about common or serious side effects, or the type of patient for whom a drug is not recommended.
Serious risks were mentioned in only 6 percent of the discussions, even though 57 percent of the medicines being promoted had side effects serious enough to warrant an FDA "black box" warning -- the highest level of precautionary message required.
And those warnings may just scratch the surface. Researchers at Stanford University recently used a new computer program to analyze adverse effects reported to the FDA for 1,332 drugs. They found an average of 329 additional side effects for each drug, or nearly 5 times more than the roughly 70 potential side effects listed in the average drug warning. The researchers also found more than 1,300 new possibly dangerous interactions between drugs.
Although many hospitals and medical practices have taken steps to limit interactions between physicians and drug company reps -- and drugmakers have adopted voluntary guidelines limiting gifts to doctors to no more than $100 -- visits, free food and drug samples, along with informational brochures, are still common in many doctors' offices.
A January study published in the journal JAMA Internal Medicine and based on surveys with 1,900 doctors in many specialties found that 40 percent of doctors who said they stay up-to-date through meetings with drug reps are more likely to prescribe brand name drugs rather than generic drugs, versus 34 percent of doctors who said they rarely or never met with the reps.
Those who received free food at their workplace or free drug samples were also more likely to prescribe brand names over generics than doctors who did not get the perks. And, overall, 37 percent of the doctors said they often or sometimes prescribed brand-name drugs if a patient asked for them, even if an equivalent generic drug was available.
Several recent analyses of Medicare data suggest that many patients are being prescribed medications that are more risky, unnecessary and expensive than patients require.
One study published by Brown University researchers in April looked at the rates of prescriptions for 110 medications for more than 6 million Medicare Advantage patients.
They reported online in the Journal of General Internal Medicine that 21.4 percent of the patients, or more than 1.3 million, received at least one high-risk medicine, and that 4.8 percent were prescribed at least two. There were also gender and geographic differences.
Women across the country had about 10-percent greater odds of getting a high risk prescription than men -- a tilt the researchers said was probably the result of riskier drugs being prescribed for conditions more common in women or that are specific only to women.
And residents of a belt across the deep South -- from Texas to South Carolina -- had 10- to 12-percent higher odds of getting a potentially harmful drug than did those living in New England.
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