US drug industry's guidelines on advertising too limited, say critics.
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ABSTRACT:
SUBMITTER: Burton B
PROVIDER: S-EPMC1188132 | biostudies-literature | 2005 Aug
REPOSITORIES: biostudies-literature
Publications
US drug industry's guidelines on advertising too limited, say critics.
BMJ (Clinical research ed.) 20050801 7514
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Project description: Not available
| S-EPMC1118336 | biostudies-literature
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| S-EPMC1125288 | biostudies-literature
Project description:IntroductionDeprescribing (medication dose reduction or cessation) is an integral component of appropriate prescribing. The extent to which deprescribing recommendations are included in clinical practice guidelines is unclear. This scoping review aimed to identify guidelines that contain deprescribing recommendations, qualitatively explore the content and format of deprescribing recommendations and estimate the proportion of guidelines that contain deprescribing recommendations.MethodsBibliographic databases and Google were searched for guidelines published in English from January 2012 to November 2022. Guideline registries were searched from January 2017 to February 2023. Two reviewers independently screened records from databases and Google for guidelines containing one or more deprescribing recommendations. A 10% sample of the guideline registries was screened to identify eligible guidelines and estimate the proportion of guidelines containing a deprescribing recommendation. Guideline and recommendation characteristics were extracted and language features of deprescribing recommendations including content, form, complexity and readability were examined using a conventional content analysis and the SHeLL Health Literacy Editor tool.Results80 guidelines containing 316 deprescribing recommendations were included. Deprescribing recommendations had substantial variability in their format and terminology. Most guidelines contained recommendations regarding for who (75%, n=60), what (99%, n=89) and when or why (91%, n=73) to deprescribe, however, fewer guidelines (58%, n=46) contained detailed guidance on how to deprescribe. Approximately 29% of guidelines identified from the registries sample (n=14/49) contained one or more deprescribing recommendations.ConclusionsDeprescribing recommendations are increasingly being incorporated into guidelines, however, many guidelines do not contain clear and actionable recommendations on how to deprescribe which may limit effective implementation in clinical practice. A co-designed template or best practice guide, containing information on aspects of deprescribing recommendations that are essential or preferred by end-users should be developed and employed.Trial registration numberosf.io/fbex4.
| S-EPMC11672013 | biostudies-literature
Project description: Not available
| S-EPMC1531641 | biostudies-literature
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| S-EPMC1122189 | biostudies-literature
Project description:ImportanceSome drugs are heavily marketed through direct-to-consumer advertising.ObjectiveTo identify drug characteristics associated with a greater share of promotional spending on advertising directly to consumers.Design, setting, and participantsExploratory cross-sectional analysis of drug characteristics and promotional spending for the 150 top-selling branded prescription drugs in the US in 2020 as identified from IQVIA National Sales Perspectives data. Promotional spending data were provided by IQVIA ChannelDynamics.ExposuresDrug characteristics (total 2020 sales; total 2020 promotional spending; clinical benefit ratings; number of indications, off-label use; molecule type; nature of condition treated; administration type; generic availability; US Food and Drug Administration [FDA] approval year, World Health Organization anatomical therapeutic chemical classification; Medicare annual mean spending per beneficiary; percent sales attributable to the drug; market size; market competitiveness) assessed from health technology assessment agencies (France's Haute Autorité de Santé and Canada's Patented Medicine Prices Review Board) and drug data sources (Drugs@FDA, the FDA Purple Book, Lexicomp, Merative Marketscan Research Databases, and Medicare Spending by Drug data).Main outcomes and measuresProportion of total promotional spending allocated to direct-to-consumer-advertising for each drug.ResultsThe 2020 median proportion of promotional spending allocated to direct-to-consumer advertising was 13.5% (IQR, 1.96%-36.6%); median promotional spending, $20.9 million (IQR, $2.72-$131 million); and median total sales, $1.51 billion (IQR, $0.97-$2.26 billion). Of the 150 best-selling drugs, 16 were missing data and key covariates; therefore, the primary study sample comprised 134 drugs. After adjustment for multiple drug characteristics, the mean proportion of total promotional spending allocated to direct-to-consumer advertising for the remaining 134 drugs was an absolute 14.3% (95% CI, 1.43%-27.2%; P = .03) higher for those with low added clinical benefit than for those with high added clinical benefit and an absolute 1.5% (95% CI, 0.44%-2.56%; P = .005) higher for each 10% increase in total sales.Conclusions and relevanceAmong top-selling US drugs in 2020, a rating of lower added benefit and higher total drug sales were associated with a higher proportion of manufacturer total promotional spending allocated to direct-to-consumer advertising. Further research is needed to understand the implications of these findings.
| S-EPMC10408265 | biostudies-literature
Project description: Not available
| S-EPMC7343624 | biostudies-literature
Project description:BackgroundGuidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity.Methodology/principal findingsWe conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines.Conclusions/significanceOur study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more explicit about the applicability of their recommendations to patients with comorbidity. Future clinical trials should also include patients with the most prevalent combinations of chronic conditions.
| S-EPMC3197602 | biostudies-literature
Project description:The gill-oxygen limitation theory (GOLT) provides mechanisms for key aspects of the biology (food conversion efficiency, growth and its response to temperature, the timing of maturation, and others) of water-breathing ectotherms (WBEs). The GOLT's basic tenet is that the surface area of the gills or other respiratory surfaces of WBE cannot, as two-dimensional structures, supply them with sufficient oxygen to keep up with the growth of their three-dimensional bodies. Thus, a lower relative oxygen supply induces sexual maturation, and later a slowing and cessation of growth, along with an increase of physiological processes relying on glycolytic enzymes and a declining role of oxidative enzymes. Because the "dimensional tension" underlying this argument is widely misunderstood, emphasis is given to a detailed refutation of objections to the GOLT. This theory still needs to be put on a solid quantitative basis, which will occur after the misconceptions surrounding it are put to rest.
| S-EPMC7787657 | biostudies-literature