A new study conducted by researchers in the United States has revealed that articles, whether negative or positive, which are published in medical journals, can influence the way doctors use medicines to treat patients.
The impact is greater in cases with negative articles regarding any particular drugs or practice. Doctors seemed to change their treatment more quickly if the article regarding response to a particular drug or treatment was negative; they seemed to react slower when the scenario was reversed. Even when an article cites a drug or treatment as potentially beneficial doctors were slower to adopt any new drug or practice.
The study was led by cardiologist Dr. Paul J. Hauptman, M.D., of the Saint Louis University School of Medicine, who along with his team, studied the records of nearly 400,000 patients who had been admitted for heart failure at 491 hospitals in the United States. In early 2005, two articles were published in two different medical journals Circulation and the Journal of the American Medical Association which suggested that the use of the drug nesiritide, which is popularly used for treating acute decompensated heart failure, increased the risk of kidney failure and death.
The Saint Louis research team analyzed the records of the hospital admissions both before and after the publication of these two articles i.e. four months prior to the publication and 8 months subsequent to the publication of the nesiritide articles. They found that after the articles were published, the medication nesiritide registered a drop in use from 16.6 percent in March 2005 to 5.6 percent in December 2005.They also found that this drop in use was highest among the elderly patients, suggesting increased concerns for the risk posed on this elderly population.
Dr. Paul J. Hauptman called the results unexpected and remarkable. "The results were notable -- and to a large extent unexpected. Not only did doctors appear to change practice when confronted with a potential safety problem, but they also did so far more rapidly than we expected," he said, in a statement. "When medications are shown to improve survival, it takes doctors longer to adopt them into practice." "If there is a safety concern and it is prominently displayed, physicians drop (the drug) like a dead weight." "With an increasing focus on drug safety, we need to recognize that the publication of research that calls into question the safety of a drug can have a great impact on physicians, and, as a consequence, on patients and drug companies, “he added.
Associate professor of medicine and study co-author Mark Schnitzler, Ph.D., of the Saint Louis University, said that articles which are published in major medical journals have quite a lot of influence on physicians. “Most doctors, academic or not, read JAMA and the New England Journal of Medicine. Most are probably just scanning the articles or monitoring media coverage of the articles, but they believe they can trust the information being presented. Now we know that the information does have a very real effect on the doctor-patient relationship,” he added.
The study details have been published in the October 18 edition of the Journal of the American Medical Association.
