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Access to information changes prescribing patterns

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Access to information changes prescribing patterns

Rapid access to information about drugs is dramatically changing prescribing patterns, says PHARMAC’s Medical Director, Dr Peter Moodie.

In the agency’s Annual Review, Peter Moodie says the evidence based medicine movement has had an enormous effect on modern medicines.

“With easier access to clinical information, a number of non-medical groups have taken a real interest in that evidence.”

Clinicians are not alone in wanting information; the public and the media are questioning safety, while economists and accountants are looking more closely at the relative value for money issues.

“Over the last year or so the burgeoning of evidence and the speed of change has had a dramatic effect on prescribing patterns.”

One of the most obvious examples, says Dr Moodie, is the impact of an international study that linked HRT with an increased risk of cancer on prescriptions.

There was a 49 percent reduction in HRT prescribing in New Zealand in 2003 and a further 32 percent this year.

“That drop was equalled only by the switch from third generation to second generation oral contraceptives in 1998.

“Clearly clinicians responded to the evidence, but at the same time the public and the media had huge parts to play in the dissemination of that evidence.”

Dr Moodie says responsible use of antibiotics has been a matter of scientific concern for some years both in New Zealand and internationally.

“Over the past five years, New Zealand has had a 16 percent drop in community antibiotic usage accompanied by a similar change in patient understanding of the issues.

“That change has occurred as a result of public interest in the issues and could not have happened without their support.”

Dr Moodie says although people will be influenced by opinion leaders, the internet has made access to research much easier.

“As patients take an increasing interest in evidence-based medicines, it is critical that health professionals remain fully informed and critically aware.”

He reports good uptake of a joint pilot scheme with the ACC to provide free access to the British Medical Journal’s Clinical Evidence publication.


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