Journal Articles Quickly Affect Doctors' Practice

Study that questioned one drug's safety triggered a rapid decline in its use, researchers note

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TUESDAY, Oct. 17, 2006 (HealthDay News) -- Negative articles in medical journals can have a major impact on your doctor's use of medicines, a U.S. study finds.

Researchers at Saint Louis University analyzed the records of nearly 386,000 heart failure patients admitted to 491 U.S. hospitals before and after two articles about the drug nesiritide were published in the journals Circulation and the Journal of the American Medical Association in early 2005.

The articles suggested that patients who took nesiritide -- which is used to treat a condition called acute decompensated heart failure -- had an increased risk of kidney failure and death.

After the articles appeared in the journals, the use of nesiritide to treat heart failure patients decreased from a high of 16.6 percent in March 2005 to 5.6 percent in December 2005. The decline was greatest among elderly patients, which reflected heightened concerns about the risks the drug posed to that population, the study said.

"The results were notable -- and to a large extent unexpected. Not only did doctors appear to change practice when confronted with a potential safety problem, but they also did so far more rapidly than we expected," lead author and cardiologist Dr. Paul J. Hauptman said in a prepared statement.

He called the findings "remarkable," especially since previous studies had found that physicians were slow to switch to new, more effective drugs.

"When medications are shown to improve survival, it takes doctors longer to adopt them into practice," Hauptman said.

The findings show that articles in major medical journals have tremendous influence over doctors, said co-author and associated professor of medicine Mark Schnitzler, who compared it to the effect that articles in Vogue have on the fashion industry.

The study is in the Oct. 18 issue of the Journal of the American Medical Association.

More information

The American Medical Association has more about medical journals.

SOURCE: Saint Louis University, news release, Oct. 17, 2006

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