E-DRUG: Inappropriate drug prescribing in Canada
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Greetings Rizwan,
The Centre for Evaluation of Medicines invited Dr Coamb's to present his
work at rounds 2 weeks ago. We distributed his book ahead of time. The
literature review was qualitative but well done. However we had serious
problems with his estimates of the costs of non-compliance. These are
based on the crudest of data with minimal cost accounting, plus a very
liberal interpretation of attribution to non-compliance.
He says that the figures are there to spur researchers on to better
research. Given the funding source, which was PMAC, some of us are
suspicious of other motives as well.
Compliance is a very difficult area to research, mainly because there is
no gold standard for compliance and the clinical implications of
compliance or non-compliance are often not at all obvious in individual
patients. We are not at all convinced that poor science, as in this case,
is better than no science at all....
Regards, anne holbrook
Anne Holbrook,MD,PharmD,MSc,FRCPC
Centre for Evaluation of Medicines, St Joseph's Hospital, and
Department of Medicine, McMaster University, Rm 4X1
Phone: (905) 522-1155 ext 5269 (SJH) or 521-2100 ext 3371 (MUMC)
FAX: 521-6136 (SJH) or 521-4971 (MUMC)
E-mail: holbrook@fhs.csu.mcmaster.ca
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