E-DRUG: Is internet prescribing safe?
------------------------------------------------------
[A not-yet-peer reviewed study in the electronic Lancet website
concludes that Internet prescribing for sildenafil is safe.
Maybe this is worth a discussion?
Copied from the Lancet website as fair use; see
http://www.thelancet.com/eprint/30/index.html
for the full article.
Wilbert Bannenberg, co-moderator E-drug]
Internet-based prescription of sildenafil: a 2104-patient series
Miles J Jones Consultative & Diagnostic Pathology, Inc, 1704 SE 11th Street,
Lee's Summit, MO 64081, USA (M J Jones MD)
Correspondence to: Dr Miles J Jones (FinalDoc@mindspring.com)
Lancet Eprint 2000; 00ART/5398: UR
Context: The Internet is becoming increasingly important as a way
for patients to acquire medical information and as a means
for patient-physician communication. Questions about appropriate
use of this new technology have been brought to the fore by
the many patients using the Internet to seek sildenafil
prescriptions.
Objective: To present the first description of a physician designed
and directed Internet-based prescribing system of sildenafil,
together with data covering more than 2100 patient encounters.
Design: Retrospective analysis of a large case series, with informal
comparison to patients seen in a conventional inner city
hospital clinic practice setting.
Setting: A medical practice that prescribes sildenafil based on
medical and sexual histories obtained through a physician
designed and directed World Wide Web site. For comparison, we
utilized patients from clinics at a Midwestern inner city
medical center.
Patients: All 2104 Internet patients seeking sildenafil prescriptions
between June 14, 1998, and March 1, 1999, and all 36
medical center patients obtaining sildenafil prescriptions during the
same period.
Main outcome measures: Completeness of medical record; patient
safety as noted by the follow up responses of all patients
requesting refills, any comments received by the internet site
(webmaster), and patient or physician comments noted in the clinic
medical record; satisfaction as noted by the follow up responses of
all patients requesting refills, any comments received by the
internet site (webmaster), and patient or physician comments
noted in the clinic medical record; examinations and laboratory
tests.
Results: Fifty-six percent of Internet requests came from 46 states,
and 44% from 8 foreign countries. Of 2104 requests,
2100 were granted. Three hundred ten patients have requested
medication refills: All reported erections sufficient for
intercourse and 69% said their satisfaction exceeded all
expectations; none were at all dissatisfied. Side effect rates were
comparable to those in the literature. Comparison of the medical
history obtained from Internet patients with that recorded in
clinic patients� charts revealed that the former was far more
complete. No clinic patient received any examination or laboratory
test specific for erectile dysfunction or its causes. There were no
reported deaths or serious complications in either group.
Conclusions: Internet-based sildenafil prescribing provides the
physician with a complete and very detailed medical and sexual
history for 100% of patients without denying any information
routinely obtained in a direct patient contact setting.
Internet-based practice, which may be expected to require far fewer
healthcare resources than traditional settings, rates very
high in patient satisfaction among patients requesting a refill and
because no negative comments were received from all other
patients. Overall, these data support the safety and effectiveness of
Internet prescribing of selected medications.
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.