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Off-Label Prescribing Common in Doctors' Offices

About one-fifth of drugs prescribed for non-approved uses

TUESDAY, May 9 (HealthDay News) -- Office-based physicians frequently prescribe drugs off-label, with approximately one-fifth of drugs prescribed in this way, often without scientific support, according to a study in the May 8 issue of the Archives of Internal Medicine.

David C. Radley, M.P.H., of Dartmouth Medical School in Hanover, N.H., and colleagues defined prescribing patterns for 160 commonly prescribed drugs using nationally representative data from the 2001 IMS Health National Disease and Therapeutic Index. The authors measured two outcomes: the proportion of off-label uses and the proportion of off-label uses with strong scientific support.

In 2001, there were an estimated 150 million off-label mentions, accounting for 21 percent of overall use. Anticonvulsants and cardiac medications were the most commonly prescribed, accounting for 46 percent each of the total. Cardiac medications excluded antihyperlipidemic and antihypertensive agents. Among specific medications, gabapentin and amitriptyline hydrochloride were the most commonly prescribed. Almost three-quarters of off-label mentions had little or no scientific support.

"The ability to prescribe medicines off-label brings greater latitude to turn scientific knowledge into innovative clinical practice," the authors conclude, but they caution that "efforts should be made to scrutinize underevaluated off-label prescribing that compromises patient safety or represents wasteful medication use."

Merck & Company, Inc. provided access to the data used in the study.

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