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If you want to find out the 8 drugs doctors would never take....ask them!

Posted Oct 01 2008 4:31pm
I recently blogged about a particularly annoying article called " 8 drugs doctors wouldn't take" that originally appeared in Men's Health and surprisingly appeared on MSNBC, which is usually pretty reputable. There were many annoyances about this piece including incorrect information and re-hashing negative data, much of which has been found to be incorrect. However, the most annoying thing about the story is that it implies that physicians were surveyed about medications they had concerns with, and in fact, I don't think ANY physicians were even asked!

In the orginal Men's Health article, they state:
"Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor."

Yet there is no mention of how many physicians they asked, how they chose these physicians, etc? In the article there are eight quotes/recommendations by five "experts," three of which came from Philip Rodgers, a Pharm.D (this is no disrespect to Pharm D's who have a great knowledge of medications and their side effects, but article is not titled "8 drugs no Pharm D would ever take").

That last sentence particularly irks me (and many of my colleagues) as well. To sell papers/create buzz, the media reports scary (and in this case, not entirely true) stories about dangerous medications, creating unnecessary worry for patients and headaches for physicians burdened with phone calls after each story hits the press.

I have given my opinion on the safety of the 8 drugs mentioned, but upon further reflection I thought, "What would real doctors say about these medicines?" So, unlike the article, I asked them.

Using Sermo, a physician only social networking site (you must be a licensed physician to join), I posted a question to its 23,000 physician members.



For all of the following medications, please respond whether in an appropriate patient you would prescribe the medication without reservation, with some hesitation due to safety concerns, or would never prescribe the medication due to safety concerns.


Here is a link to the results. After about a day, I got responses from 59 actual physicians. There was overwhelming dissatisfaction with this article, and substantial disagreement with the articles "findings". For all but Ketek, only a few doctors out of the 59 said they would never prescribe these medications. For Advair, 3/4 said they would prescribe without reservation, 1/4 with some hesitation and only 1 said never. For the much maligned Avandia, 2/3 would prescribe without reservation, 1/4 with some hesitation, and only 6/55 physicians said they would never prescribe. Even Celebrex, the Vioxx cousin, though doctors were split on no reservation and some hesitation, only 4/58 said they would never prescribe it. Virtually every doctor said they would prescribe Prilosec and Nexxium without reservation, with only 1 never prescriber.

This is certainly not a scientific survey. However, it is far more scientific then the Men's Health article, asked actual physicians, and is much more reflective of the collective medical wisdom.

Doctors, I hope you will refer patients to this post when they come in asking about the article. Patients, please don't believe everything you read regarding the dangers of medications, especially what most physicians would and would not do.

Special thanks to all my colleagues on Sermo who responded to the question. (Since the survey is still open, I will post the final results on this blog in mid-July).
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