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duminică, 11 decembrie 2011

Medical Disinformation On The Internet

Main Category: IT / Internet / E-mail
Also Included In: Pharmacy / Pharmacist
Article Date: 10 Dec 2011 - 0:00 PST

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Spam advertising of pharmaceutical products is leading patients to seek out information about prescription drugs online, according to a report to be published in the International Journal Business and Systems Research. If those drugs are not available to the internet user through their physician there is a risk that they may obtain such products via illicit means.

The direct advertising of pharmaceutical products to patients is outlawed in several countries, but spam marketing is all-pervasive and wholly ignores national and international laws. It exists because a sale to even a tiny percentage of the hundreds of millions of people targeted every single day with product offers nets the spammers a profit. Now, Sanjoy Ghose and Vikas Lachhwani of the University of Wisconsin-Milwaukee, have investigated how exposure to spam offering prescription pharmaceuticals motivates individuals to seek additional information on the internet.

Prescription drugs improve health and extend life for many millions of people and it is perhaps natural that patients will seek information about their medication from a variety of sources other than their medical practitioner despite the fact that it is only such a practitioner who can legally prescribe that medication. However, the relationship between patient and pharmaceutical company has changed significantly over the last few decades, and most recently with the advent of the commercial internet and the World Wide Web.

"Over the last few decades, there has been a marked change in the way firms view the patient-drug interface," the team reports. "Patients are now more like 'consumers' and prescription drugs 'consumer products. Marketers now communicate directly with consumers through advertisements where it is legal to do so." There has been much debate over DTCA, direct-to-consumer advertising, but little ongoing discussion of the effect of internet-based communication on consumers. Specifically, there have been very few empirical analyses on the determinants of information seeking over the internet for prescription drugs, the team asserts. They point out that most of the earlier research has focused on consumers' responses in terms of interaction with physicians, and requests for specific drugs after exposure to advertising.

The team's study reveals that exposure to prescription drug spam motivates patients to seek further information over the internet. The reason for this could be the skepticism associated with advertising in general and especially for the case of unregulated spam-based advertising. However, the finding is a double-edged sword as the information seeking might also be associated with attempting to procure prescription medication from sources other than a medical practitioner. The data they report should help move the debate in this area forward and allow policy makers to better determine the impact of medical marketing on patients.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our it / internet / e-mail section for the latest news on this subject. "Online information seeking for prescription drugs" in Int. J. Business and Systems Research, 2011, 6, 1-17

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posted by Dr Armitage on 10 Dec 2011 at 10:19 pm

I am always amazed at patients who will spend a few minutes or hours on the internet and then bring me information that they have cherry-picked to their liking.

I remind them that I had 16 years education prior to medical school, and 4 years there and then 4 years of residency with intensive study, and then 16 years practicing medicine since then. I then ask them about the level of certainty that they have on their internet information.

The point is, I had my 10,000 hours necessary to be a master at my art about 20,000 hours ago. There is no way that they can spend 3 or 10 or 100 hours looking up internet information and even approach my level of expertise.

Most of them get it, and are reassured in my care. Some few steadfastly hold to their opinions in the face of such overwhelming logic, which just shows the truism that you can lead a horse to water but you can't make him drink!

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joi, 8 decembrie 2011

Medical Marijuana Could Help Patients Reduce Pain With Opiates

Main Category: Pain / Anesthetics
Also Included In: Alcohol / Addiction / Illegal Drugs
Article Date: 08 Dec 2011 - 1:00 PST

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A UCSF study suggests patients with chronic pain may experience greater relief if their doctors add cannabinoids - the main ingredient in cannabis or medical marijuana - to an opiates-only treatment. The findings, from a small-scale study, also suggest that a combined therapy could result in reduced opiate dosages.

More than 76 million Americans suffer from chronic pain - more people than diabetes, heart disease and cancer combined, according to the National Centers for Health Statistics.

"Pain is a big problem in America and chronic pain is a reason many people utilize the health care system," said the paper's lead author, Donald Abrams, MD, professor of clinical medicine at UCSF and chief of the Hematology-Oncology Division at San Francisco General Hospital and Trauma Center (SFGH). "And chronic pain is, unfortunately, one of the problems we're least capable of managing effectively."

In a paper published this month in Clinical Pharmacology & Therapeutics, researchers examined the interaction between cannabinoids and opiates in the first human study of its kind. They found the combination of the two components reduced pain more than using opiates alone, similar to results previously found in animal studies.

Researchers studied chronic pain patients who were being treated with long-acting morphine or long-acting oxycodone. Their treatment was supplemented with controlled amounts of cannabinoids, inhaled through a vaporizer. The original focus was on whether the opiates' effectiveness increased, not on whether the cannabinoids helped reduce pain.

"The goal of the study really was to determine if inhalation of cannabis changed the level of the opiates in the bloodstream," Abrams said. "The way drugs interact, adding cannabis to the chronic dose of opiates could be expected either to increase the plasma level of the opiates or to decrease the plasma level of the opiates or to have no effect. And while we were doing that, we also asked the patients what happened to their pain."

Abrams and his colleagues studied 21 chronic pain patients in the inpatient Clinical and Transitional Science Institute's Clinical Research Center at SFGH: 10 on sustained-release morphine and 11 on oxycodone. After obtaining opiate levels from patients at the start of the study, researchers exposed them to vaporized cannabis for four consecutive days. On the fifth day, they looked again at the level of opiate in the bloodstream. Because the level of morphine was slightly lower in the patients, and the level of oxycodone was virtually unchanged, "one would expect they would have less relief of pain and what we found that was interesting was that instead of having less pain relief, patients had more pain relief," Abrams said. "So that was a little surprising."

The morphine group came in with a pain score of about 35, and on the fifth day, it decreased to 24 - a 33 percent reduction. The oxycodone group came in with an average pain score of about 44, and it reduced to 34 - a drop of 20 percent. Overall, patients showed a significant decrease in their pain.

"This preliminary study seems to imply that people may be able to get away perhaps taking lower doses of the opiates for longer periods of time if taken in conjunction with cannabis," Abrams said.

Opiates are very strong powerful pain medicines that can be highly addictive. They also can be deadly since opiates sometimes suppress the respiratory system.

As a cancer doctor, Abrams was motivated to find safe and effective treatments for chronic pain. Patients in the cannabis-opiates study experienced no major side effects such as nausea, vomiting or loss of appetite.

"What we need to do now is look at pain as the primary endpoint of a larger trial," he said. "Particularly I would be interested in looking at the effect of different strains of cannabis."

For instance, Delta 9 THC is the main psychoactive component of cannabis but cannabis contains about 70 other similar compounds with different effects. One of those is cannabidiol, or CBD. It appears to be very effective against pain and inflammation without creating the "high" created by THC.

"I think it would be interesting to do a larger study comparing high THC versus high CBD cannabis strains in association with opiates in patients with chronic pain and perhaps even having a placebo as a control," Abrams said. "That would be the next step."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pain / anesthetics section for the latest news on this subject. Abrams is the lead author of the paper; co-authors are Paul Couey, BA, and Mary Ellen Kelly, MPH, of the UCSF Division of Hematology-Oncology at SFGH; Starley Shade, PhD, of the UCSF Center for AIDS Prevention Studies; and Neal Benowitz, MD, of the UCSF Division of Clinical Pharmacology and Experimental Therapeutics.
The study was supported by funds from the National Institutes on Drug Abuse (NIDA), a subsidiary of the National Institutes of Health (NIH).
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