Objective evaluation of generic-specific drug information.
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Growth in the use of generic drugs remains flat in Japan, and one of the reasons cited is information availability. We previously showed that the amount of information available on generic drugs differs greatly from one pharmaceutical industry to another, though, on average, it is inferior to that for original, brand name drugs. This report looks at information on individual generic drug products, rather than the active ingredients contained therein. In May 2004, we studied ingredients sold by at least 20 pharmaceutical industries. Here, for the same, particular ingredient, we evaluate current availability of generic-specific information (as of August 2005), as well as change over time. On the basis of ingredient, the amount of information provided for generic drugs is 31.1+/-17.5-57.3+/-11.7% that for the corresponding original drugs (Mean+/-S.D.), but in the company-by-company comparison, a large dispersion of 16.6+/-5.0-69.4+/-11.9% (Mean +/-S.D.) is observed. In terms of information content, generic drugs provided less than 50% as much information on "drug interactions", "clinical efficacy", and "outline of side effects", as that for original drugs. The difference between generic and original drugs was smaller in comparisons focusing on information specific to generics than on those including all drug information. Our study also revealed that, over time, some pharmaceutical industries have added to the amount of information provided. When information is a deciding factor, the quantity available at the current time is not the only relevant aspect; it is best to select a pharmaceutical industry that is proactive about supplementing information post-release. (+info)
Clinical decision support tools: analysis of online drug information databases.
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BACKGROUND: Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases. METHODS: Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness. RESULTS: The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0.001). CONCLUSION: Online drug information databases, which belong to clinical decision support, vary in their ability to answer questions across a range of categories. (+info)
Physicians' experiences using commercial e-prescribing systems.
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Public and private efforts are under way to promote electronic prescribing to improve health care safety, quality, and efficiency. Findings from this qualitative study of physician practices suggest that substantial gaps may exist between advocates' vision of e-prescribing and how physicians use commercial e-prescribing systems today. While physicians were positive about the most basic e-prescribing features, they reported major barriers to maintaining complete patient medication lists, using clinical decision support, obtaining formulary data, and electronically transmitting prescriptions to pharmacies. Three factors help explain the gaps: product limitations, external implementation challenges, and physicians' preferences about using specific product features. (+info)
Promotional methods used by representatives of drug companies: a prospective survey in general practice.
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OBJECTIVE: To examine the extent and composition of pharmaceutical industry representatives' marketing techniques with a particular focus on drug sampling in relation to drug age. DESIGN: A group of 47 GPs prospectively collected data on drug promotional activities during a six-month period, and a sub-sample of 10 GPs furthermore recorded the representatives' marketing techniques in detail. SETTING: Primary healthcare. SUBJECTS: General practitioners in the County of Funen, Denmark. MAIN OUTCOME MEASURES: Promotional visits and corresponding marketing techniques. RESULTS: The 47 GPs recorded 1050 visits corresponding to a median of 19 (range 3 to 63) per GP in the six months. The majority of drugs promoted (52%) were marketed more than five years ago. There was a statistically significant decline in the proportion of visits where drug samples were offered with drug age, but the decline was small OR 0.97 (95% CI 0.95;0.98) per year. Leaflets (68%), suggestions on how to improve therapy for a specific patient registered with the practice (53%), drug samples (48%), and gifts (36%) were the most frequently used marketing techniques. CONCLUSION: Drug-industry representatives use a variety of promotional methods. The tendency to hand out drug samples was statistically significantly associated with drug age, but the decline was small. (+info)
GPs' thoughts on prescribing medication and evidence-based knowledge: the benefit aspect is a strong motivator. A descriptive focus group study.
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OBJECTIVE: To describe GPs' thoughts of prescribing medication and evidence-based knowledge (EBM) concerning drug therapy. DESIGN: Tape-recorded focus-group interviews transcribed verbatim and analysed using qualitative methods. SETTING: GPs from the south-eastern part of Vastra Gotaland, Sweden. SUBJECTS: A total of 16 GPs out of 178 from the south-eastern part of the region strategically chosen to represent urban and rural, male and female, long and short GP experience. METHODS: Transcripts were analysed using a descriptive qualitative method. RESULTS: The categories were: benefits, time and space, and expert knowledge. The benefit was a merge of positive elements, all aspects of the GPs' tasks. Time and space were limitations for GPs' tasks. EBM as a constituent of expert knowledge should be more customer adjusted to be able to be used in practice. Benefit was the most important category, existing in every decision-making situation for the GP. The core category was prompt and pragmatic benefit, which was the utmost benefit. CONCLUSION: GPs' thoughts on evidence-based medicine and prescribing medication were highly related to reflecting on benefit and results. The interviews indicated that prompt and pragmatic benefit is important for comprehending their thoughts. (+info)
Preparing students for community pharmacy practice during a drug information advanced practice experience.
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OBJECTIVE: To determine whether students completing an advanced pharmacy practice experience (APPE) at an academic-affiliated drug information center received questions similar to those received by pharmacists practicing in community settings. METHODS: Graduates of Samford University McWhorter School of Pharmacy residing in Southeastern states were surveyed via US mail to determine the characteristics of inquiries received from health care providers and the public in community practice. Survey results were compared to inquiries received at Samford University Global Drug Information Center (SUGDIS). RESULTS: The response rate to the survey of graduates was 36% (268 of 738 surveys). Respondents identified nonprescription drugs (65%), adverse drug reactions (62.7%), and drug interactions (62.4%) as the top 3 types of questions answered routinely in community practice, while drug therapy (13.9%), dosing (10.2%), and adverse drug reactions (6.5%) were the 3 types of questions most commonly answered at SUGDIS. The most common resources used to answer questions in the community and SUGDIS were Drug Facts and Comparisons and specialty references, respectively. CONCLUSIONS: Differences were noted in types of questions received, expected speed of response, and reference utilization. As a result, activities were incorporated into the drug information APPE to address the disparities noted in the study. (+info)
Identification of new drug classification terms in textual resources.
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Knowledge about biological effects of small molecules helps in the understanding of biological processes and supports the development of new therapeutic agents. DrugBank is a high quality database providing such information about drugs that contains annotation of drug effects and classification of therapeutic effects. However, to broaden the scope of such a database in classifying and annotating drugs, systems for automatic extraction of classification terms and the corresponding annotation of drugs are needed. We have developed an approach for the identification of new terms used in unstructured text that provide information about drug properties. It is based on the identification and extraction of phrases corresponding to lexico-syntactic patterns--so-called Hearst patterns that contain drug names and directly related drug annotation terms. Such phrases could be identified with a high performance in DrugBank text (0.89 F-score) and in Medline abstracts (0.83 F-score). In comparison to DrugBank annotation terminology, a huge amount of new drug annotation terms could be found. The evaluation of terms extracted from Medline showed that 29-53% of them are new valid drug property terms. They could be assigned to existing and new drug property classes not provided by the DrugBank drug annotation. We come to the conclusion that our system can support database content update by providing additionally drug descriptions of pharmacological effects not yet found in databases like DrugBank. Moreover, we propose that automatic normalization of terms improves the annotation and the retrieval of relevant database entries. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online. (+info)
Off-label utilization of antihypertensive medications in children.
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OBJECTIVE: To examine off-label use and costs of antihypertensive drugs in children by using a national sample of prescription claims. METHODS: We conducted a cross-sectional study using the 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children or=12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged +info)