Drugs online research references
J Am Board Fam Pract. 2002 Nov-Dec;15(6):457-62.
Influence of new evidence on prescription patterns.
Calvo CB, Rubinstein A.
Division of Family and Preventive Medicine, Hospital Italiano, Universidad de Buenos Aires, Argentina.
BACKGROUND: It is currently accepted that no drug can enter clinical practice without proved efficacy in clinical trials. Improving patient care requires that the results of clinical evaluation be translated into practice. Results of studies are conflicting, but there is support that well-executed, clinically relevant randomized trials published in highly visible clinical journals can have an effect on patterns of medical practice. METHODS: We evaluated the potential impact of the publication in a leading journal of different drug studies (metformin, alendronate, terazosin, and finasteride) on the prescription behavior of generalists and specialists. Using a health maintenance organization (HMO) prescription drug database, we analyzed the incidence of new prescriptions written by generalists and specialists from a university-affiliated HMO before and after the publication date of the studies. RESULTS: The proportions of new prescriptions changed between a 6-month period before publication and a 6-month period after publication. The rate for alendronate increased from 31.7% to 43.2% of all prescriptions for specialists (P = NS) and from 8.8% to 38.9% for generalists (P < .01). The rate for metformin increased from 26.7% to 46.4% for specialists (P = .04) and from 7.9% to 24.2% for generalists (P < .01). The rate for alpha1-blockers decreased from 48.7% to 38.9% (P = NS) for specialists and increased from 20.7% to 60% for generalists (P < .01). The rate for finasteride decreased from 40.9% to 19.64% for specialists (P < .01) and from 22.11% to 11.3% for generalists (P = .01). CONCLUSIONS: The change in the prescription patterns of all physicians showed a clear temporal association with the publication of new evidence. The greater change observed for generalists could be explained by their lower baseline use of the drugs and a more conservative behavior that might defer the adoption of new treatments until they are supported by strong evidence published in major journals.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12463291&dopt=Abstract
Prostate Cancer Prostatic Dis. 1999 May;2(3):110-119.
Alpha-1-adrenoceptor blockade in the treatment of benign prostatic hyperplasia.
Lowe F.
Department of Urology, St. Luke's-Roosevelt Hospital Center, 425 West 59th Street, New York, NY 10019.
In light of the growing interest in the concept of 'uroselectivity' and in the increased worldwide use of alpha-blockers for benign prostatic hyperplasia (BPH), this review evaluates the relative benefits of various alpha-blocking agents in the treatment of BPH. The pharmacological and physiological selectivity as well as the clinical efficacy and safety of alfuzosin, doxazosin (Cardura(R)), tamsulosin (Flomax(R)), and terazosin (Hytrin(R)) are compared. In reviewing efficacy and safety, emphasis is given to 17 placebo-controlled, double-blind trials of these alpha-blockers published in peer-reviewed journals. This review also considers long-term data, effects on blood pressure, costs, and dose ranges.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12496820&dopt=Abstract [PubMed - as supplied by publisher]
Prostate Cancer Prostatic Dis. 2001;4(S1):S12-S16.
Impact of treatment of BPH on sexuality.
Schulman C.
Department of Urology, Erasme Hospital, University of Clinics of Brussels, Belgium.
Benign prostatic hyperplasia (BPH) can have a profound affect on a patient's quality of life and sexual function and is considered by patients to be one of the most important aspects affected by the disease. Different treatments can produce a variable response in terms of the patient's quality of life, including sexual activity and satisfaction. Varying rates of erectile dysfunction (ED) and retrograde ejaculation following surgery for BPH have been reported. In general, the incidence of these side-effects is less after minimally invasive therapies, such as interstitial laser coagulation and transurethral microwave therapy, but the data available are limited. The lowest rates of sexual dysfunction are reported with medical therapies. The 5alpha-reductase inhibitor, finasteride, can result in ED in 5-9% of patients and ejaculation disorders in 0.8-2.0%. With the exception of tamsulosin, alpha(1) blockers are associated with a low rate of sexual dysfunction. No cases of ED have been reported with alfuzosin and abnormal ejaculation with terazosin or alfuzosin is negligible. Indeed, early research suggests a beneficial effect of alpha(1) blockers on sexual function. In addition to information on the efficacy of a particular therapy, patients should be informed of side effects, in particular those relating to sexual function, in order that they can make informed treatment decisions.Prostate Cancer and Prostatic Diseases (2001) 4, S12-S16
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12497054&dopt=Abstract [PubMed - as supplied by publisher]
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