E-DRUG: Save the Drug Therapeutics Bulletin! (8)
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There are 3 questions
1) Is printed drug information worthwhile?
2) Is it better for drug bulletins to be funded by government or readers
subscriptions?
3) What is the best response to the UK Health Dept decision to stop funding
The Drugs and Therapeutics Bulletin (DTB)?
1) Is printed drug information worthwhile?
Printed information for health professionals written by health professionals
is not reliably effective at directly influencing prescribing. However it
works sometimes eg. when doctors have a perceived need for information.
Printed advertisements targeting health professionals written by advertising
agencies are effective particularly for raising awareness of new drugs and
for maintaining ongoing prescribing.
Independent drug bulletins are not sufficient for changing prescribing but
they are necessary.
I will repeat the house metaphor I suggested during a similar discussion on
e-drug several years ago.
Foundations: RCTs, economic analysis, qualitative studies.
Walls: Systematic reviews, independent bulletins
Roof: Education and Social marketing
A foundation alone is not sufficient to protect you from the weather but it
is necessary before you can build the walls and then the roof.
Building a good foundation and/or good walls is worthwhile.
Independent bulletins influence prescribing indirectly via influencing the
educators and social marketers. If prescribing is not improving then you
need to evaluate the different functions appropriately to see which needs to
be strengthened first.
2) Is it better for drug bulletins to be funded by government or readers
subscriptions?
Both options have pros and cons. I am not aware of any controlled trial
evidence re which is best. It may be best to have both. What is best may
vary from country to country. It makes sense to let each bulletin decide for
itself what it thinks will work best and support them whatever they decide.
3) What is the best response to the UK Health Dept decision to stop funding
The Drugs and Therapeutics Bulletin (DTB)?
I have received information that the situation is complex.
It is not clear why the UK Health Dept think it is a good idea to stop this
funding. It may be that they think:
doctors are relatively well paid
doctors like the bulletin
so all who currently read it will be willing to pay for it
so no harm will be done and govt funds will be available for other projects.
If so, campaigning expressing support for the bulletin from doctors may only
lead the department to believe that they have made the right decision.
It would be more effective to have a campaign by consumers and patients
groups.
I think the best we can do is campaign for an evaluation of the impact of this decision
and /or
transition funding to enable DTB to keep the current team going until they
have learned how to sell enough subscriptions to survive.
If a team who do not have experience at selling subscriptions has all
funding cut (rather than funding increased temporarily to pay for
advertising) then it may collapse. It takes a few years to build up enough
subscriptions to be viable. Transition funding should come from the
government and/or the UK Consumers' Association that owns DTB.
regards,
Peter
Dr Peter R Mansfield
GP
Director, Healthy Skepticism Inc. Countering misleading drug promotion.
www.healthyskepticism.org
peter@healthyskepticism.org
Research Fellow, Discipline of General Practice, University of Adelaide.
www.adelaide.edu.au/directory/peter.mansfield
peter.mansfield@adelaide.edu.au