Posted in Uncategorized, tagged defensive medicine, drug information, drug side-effects, generic drugs, great medical care, medications, patient safety, pharmaceutical companies, pharmaceuticals, prescription information on August 26, 2010|
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Sometimes, there is not one right answer to the problems faced in medicine (or in any other field). For example, we want drugs that have awesome efficacy. We want drugs that are extremely safe. We want drugs that are affordable. It’s not likely we’ll get all three (or even two of the three) at once.
Providing the best information about prescription medications to patients is another conundrum. As pointed out in a recent publication (Winterstein AG, Linden S, Lee AE, Fernandez EM, Kimberlin CL. Evaluation of consumer medication information dispensed in retail pharmacies. Arch Intern Med. 2010;170:1317-24), the law requires that most prescriptions be accompanied by useful written consumer medication information.
But what does “useful” mean exactly? Putting together a “useful” handout that is readable and has the basic information is certainly going to help patients, but it is also presents a risky situation for the manufacturer. Of course “useful” information includes material that is understandable and necessary to understand and correctly use the medication. But should every side effect be included? Where do you draw the line between side effects that are common and those that are too rare to include? And if you do exclude any, how would patients feel if they developed a known rare side effect that was left out of the brochure?
National Public Radio quotes Joe Graedon — a pharmacologist, host of the People’s Pharmacy and an expert on practical drug information — as saying that there are only a few key things people really need to know about their drugs:
- how to take the drug
- the most common side effects
- symptoms to watch out for and what to do if they happen
That’s sensible advice. However, there are many of lawyers out there — you’ve seen their ads on TV. With so many of them around, how will people justify excluding information for patients about even the rarest of risks, and making the brochures so long and so technical that they are no longer considered “useful?”
Note: I have been a big fan of Graedons’ Peoples Pharmacy program for years and have been a guest on the show a few times. You should check it out here. It is a terrific medical resource.
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Posted in patient satisfaction, tagged customer satisfaction, doctor-patient relationship, DrScore, drscore.com, great medical care, medical legal risk, medical malpractice, patient complaints, patient responsibility, patient safety, reducing malpractice risk on August 16, 2010|
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I received an e-mail invitation to attend a medical-legal seminar on reducing risks. I’m not sure what they are going to cover, but clearly, the No. 1 way to reduce medical legal risks is for doctors to give patients great quality medical care. Patients also need to perceive the quality of care is great. That is why obtaining feedback from a patient satisfaction survey service like DrScore is a necessary component to assessing and assuring patient satisfaction.
Great medical care is really a partnership. Patients can reduce their risk of being in the kind of situation that results in medico-legal liability by taking more responsibility for their own care. Patients should get a copy of their medical records, particularly the results of laboratory work that is done. That will help make certain nothing falls through the cracks in a system that has shown itself to have too many cracks.
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Avandia, a medicine used to treat diabetes, has been the subject of news and controversy. Concerns have been raised about the drug potentially causing an increased risk of heart attacks compared to other treatment options. An FDA panel reviewed the evidence and voted 20-12 to keep Avandia on the market.
The controversy around Avandia is complicated. Concerns were expressed that the manufacturer may have downplayed or hidden evidence of problems with the drug. But so far, a detailed examination of the evidence didn’t lead the FDA panel to call for sales of the drug to stop.
In some of the latest news about the controversy, a couple of members of the FDA panel that reviewed the drug were found to have been paid in the past for services to the company that makes Avandia or by the company that makes the competing product (Wall Street Journal). I doubt this affected the panel deliberations or decision in any substantive way.
The bottom line is that understanding the safety of drug products is really quite difficult. In the case of Avandia, it’s easy (well, at least relatively easy) to show that the drug helps patients control their sugar level. It’s much harder to know if there’s a small increased risk of heart attacks or how big that small increased risk is. If you are taking Avandia, the best course is probably to speak to your doctor about it.
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