Of Pens, Pizzas, and Pharmaceuticals

2016 ◽  
Vol 22 (2) ◽  
Author(s):  
Peter J. Pitts
Keyword(s):  
Internal Medicine ◽  
Pharmaceutical Industry ◽  
Prescribing Patterns ◽  
Medicare Beneficiaries ◽  
Treatment Needs ◽  
Much Ado About Nothing ◽  
Physician Prescribing ◽  
Open Payments

Much ado about pharma freebies to physicians. Much ado about nothing medically and everything politically. A new study published by JAMA Internal Medicine (Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries)makes it sound (as Meagan McArdle has written for Bloomberg), that your doctor is “willing to sell you out for the price of a sandwich.” It’s not that simple … or true.A valuable takeaway from the new JAMA study should be that wide adoption of Open Payments reporting has led to transparent interactions and value exchanges of education, money and meals between the pharmaceutical industry and prescribers. These data are now available to inform and improve educational efforts to meet the treatment needs of patients using the latest advances in medicine and science. However, such data must be cautiously interpreted with full acknowledgement of study limitations and author bias. 

scholarly journals Pharmaceutical Industry–Sponsored Meals and Physician Prescribing Patterns for Medicare Beneficiaries

2016 ◽  
Vol 176 (8) ◽  
pp. 1114 ◽  
Author(s):  
Colette DeJong ◽  
Thomas Aguilar ◽  
Chien-Wen Tseng ◽  
Grace A. Lin ◽  
W. John Boscardin ◽  
...  
Keyword(s):  
Pharmaceutical Industry ◽  
Prescribing Patterns ◽  
Medicare Beneficiaries ◽  
Physician Prescribing

Antidepressant Side Effects and Physician Prescribing Patterns

1993 ◽  
Vol 5 (1) ◽  
pp. 7-11 ◽  
Author(s):  
John Huszonek ◽  
Mantosh Dewan ◽  
Marvin Koss ◽  
William Hardoby ◽  
Abbas Ispahani
Keyword(s):  
Side Effects ◽  
Prescribing Patterns ◽  
Physician Prescribing

scholarly journals Development of the individualised Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education (iCOMPARE) trial: a protocol summary of a national cluster-randomised trial of resident duty hour policies in internal medicine

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021711 ◽  
Author(s):  
Judy A Shea ◽  
Jeffrey H Silber ◽  
Sanjay V Desai ◽  
David F Dinges ◽  
Lisa M Bellini ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Patient Safety ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Medicare Beneficiaries ◽  
Internal Medicine Training ◽  
Duty Hours ◽  
Time Motion ◽  
Wrist Actigraphy ◽  
Resident Duty

IntroductionMedical trainees’ duty hours have received attention globally; restrictions in Europe, New Zealand and some Canadian provinces are much lower than the 80 hours per week enforced in USA. In USA, resident duty hours have been implemented without evidence simultaneously reflecting competing concerns about patient safety and physician education. The objective is to prospectively evaluate the implications of alternative resident duty hour rules for patient safety, trainee education and intern sleep and alertness.Methods and analysis63 US internal medicine training programmes were randomly assigned 1:1 to the 2011 Accreditation Council for Graduate Medical Education resident duty hour rules or to rules more flexible in intern shift length and number of hours off between shifts for academic year 2015–2016. The primary outcome is calculated for each programme as the difference in 30-day mortality rate among Medicare beneficiaries with any of several prespecified principal diagnoses in the intervention year minus 30-day mortality in the preintervention year among Medicare beneficiaries with any of several prespecified principal diagnoses. Additional safety outcomes include readmission rates, prolonged length of stay and costs. Measures derived from trainees’ and faculty responses to surveys and from time-motion studies of interns compare the educational experiences of residents. Measures derived from wrist actigraphy, subjective ratings and psychomotor vigilance testing compare the sleep and alertness of interns. Differences between duty hour groups in outcomes will be assessed by intention-to-treat analyses.Ethics and disseminationThe University of Pennsylvania Institutional Review Board (IRB) approved the protocol and served as the IRB of record for 40 programmes that agreed to sign an Institutional Affiliation Agreement. Twenty-three programmes opted for a local review process.Trial registration numberNCT02274818; Pre-results.

Patterns of Prescription Drug Use: The Role of Promotion

1973 ◽  
Vol 3 (4) ◽  
pp. 389-402 ◽  
Author(s):  
C. Joseph Stetler
Keyword(s):  
Drug Abuse ◽  
Prescription Drug ◽  
Prescribing Patterns ◽  
Pharmaceutical Manufacturers ◽  
Prescription Drug Use ◽  
Drug Promotion ◽  
Promotional Efforts ◽  
The Subject ◽  
Physician Prescribing

Promotional efforts directed to the health professions by pharmaceutical manufacturers, and their alleged association with excessive prescribing and drug abuse are the subject of this paper. The paper contends that claims to the effect that legitimate drug prescribing patterns and promotional efforts merely mirror—or even may cause—drug abuse are not factually supported. Assertions to the effect that physicians rely primarily on advertising in making prescribing decisions are not borne out by studies of the various factors which bear upon those decisions, the paper points out. It describes the extent of prescription drug promotion, and utilization and notes that physician prescribing of psychoactive drugs has lagged behind overall prescription growth trends, in contrast to the accelerating misuse and abuse of this class of medications in the community at large.

scholarly journals Temporal Trends in Opioid Prescribing Patterns Among Oncologists in the Medicare Population

2020 ◽  
Author(s):  
Vikram Jairam ◽  
Daniel X Yang ◽  
Saamir Pasha ◽  
Pamela R Soulos ◽  
Cary P Gross ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Temporal Trends ◽  
State Level ◽  
Negative Binomial Regression ◽  
Time Frame ◽  
Prescribing Patterns ◽  
Annual Number ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Opioid Prescribing

Abstract Background In the wake of the US opioid epidemic, there have been efforts to curb opioid prescribing. However, it is unknown whether these efforts have affected prescribing among oncologists, whose patients often require opioids for symptom management. We investigated temporal patterns in opioid prescribing for Medicare beneficiaries among oncologists and nononcologists. Methods We queried the Centers for Medicare and Medicaid Services Part D prescriber dataset for all physicians between January 1, 2013, and December 31, 2017. We used population-averaged multivariable negative binomial regression to estimate the association between time and per-provider opioid and gabapentinoid prescribing rate, defined as the annual number of drug claims (original prescriptions and refills) per beneficiary, among oncologists and nononcologists on a national and state level. Results From 2013 to 2017, the national opioid-prescribing rate declined by 20.7% (P < .001) among oncologists and 22.8% (P < .001) among non oncologists. During this time frame, prescribing of gabapentin increased by 5.9% (P < .001) and 23.1% (P < .001) among oncologists and nononcologists, respectively. Among palliative care providers, opioid prescribe increased by 15.3% (P < .001). During the 5-year period, 43 states experienced a decrease (P < .05) in opioid prescribing among oncologists, and in 5 states, opioid prescribing decreased more among oncologists than nononcologists (P < .05). Conclusions Between 2013 and 2017, the opioid-prescribing rate statistically significantly decreased nationwide among oncologists and nononcologists, respectively. Given similar declines in opioid prescribing among oncologists and nononcologists, there is concern that opioid-prescribing guidelines intended for the noncancer population are being applied inappropriately to patients with cancer and cancer survivors.

scholarly journals Promotional Payments Made to Urologists by the Pharmaceutical Industry and Prescribing Patterns for Targeted Therapies

Urology ◽  
2020 ◽  
Author(s):  
Brent K. Hollenbeck ◽  
Mary Oerline ◽  
Samuel R. Kaufman ◽  
Megan E.V. Caram ◽  
Stacie B. Dusetzina ◽  
...  
Keyword(s):  
Pharmaceutical Industry ◽  
Targeted Therapies ◽  
Prescribing Patterns
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