Informing physicians about promising new treatments for severe illnesses

Article Abstract:

Recently it has become more common for physicians to hear of new drug treatments at the same time the general public is informed. Through the increased use of unconventional communication networks, such as press releases, press conferences, and direct mailings, the announcement of some new treatments has preceded traditional forms of communication such as the presentation of data at medical meetings or publication of the findings in peer-reviewed medical journals. When information comes from sources such as press releases, the physician is frequently not provided with enough detail to adequately evaluate the new study, or to answer patients' questions or make appropriate recommendations. In some cases, a new drug may actually be made available prior to the publication of study results, as was the case for levamisole, a chemotherapy drug for colon cancer that was announced on June 23, 1989. Also, the AIDS crisis in this country has streamlined the announcement and release of new drug treatments prior to providing doctors with an opportunity to evaluate the research data. In February 1989, aerosolized pentamidine prophylaxis treatment for Pneumocystis carinii pneumonia, which is a frequent and often fatal complication of AIDS, was publicized by the drug manufacturer and the Federal Food and Drug Administration (FDA). This occurred before physicians had access to the studies the FDA based its action upon. Doctors were put in the position of having patients request a drug that they knew nothing about. To improve this communication problem, a number of strategies have been suggested. More information could be provided by the unconventional communications; the FDA could make information more readily available to doctors; earlier submission of data to medical journals and more rapid review once submitted would inform physicians more promptly; and computerized information sources could be expanded. Improved communication to physicians regarding new treatments will result in better patient care and will most likely save or prolong the lives of some individuals with severe illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Management, Evaluation, Physicians, Medical professions, Drug therapy, Communication in medicine, Medical communication, Drug utilization, Drug monitoring

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Health care workers infected the human immunodeficiency virus: the next steps

Article Abstract:

The activities of health care workers infected with the human immunodeficiency virus (HIV) may be restricted to prevent transmission of HIV to their patients. The Centers for Disease Control (CDC) has estimated that the risk of contracting HIV from an infected health care worker is between one in 42,000 and one in 420,000. Many patients are concerned about contracting HIV from infected health care workers, and believe that HIV-infected health care workers should not be allowed practice. In Jul 1991, the CDC recommended that a panel of medical experts decide on a case-by-case basis whether HIV-infected health care workers can perform surgeries and other invasive procedures. It also recommended that all health care workers should undergo HIV testing. These recommendations are under review as of Feb 1992. Health care workers should try to protect their patients from HIV infection, but their own right to privacy and a livelihood should be protected also.

Prevention, HIV infection, HIV infections, Diseases, Medical personnel

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The Oregon Medicaid demonstration project - will it provide adequate medical care?

Article Abstract:

The Oregon state legislature recently passed a law that would give basic health care benefits to more residents by limiting the number of services reimbursed by Medicaid. But certain individuals may have more severe symptoms than another individual with the same disease. The plan does not account for co-existing diseases, which might worsen a patient's prognosis. Many physicians may object to practicing medicine by a list that excludes many accepted treatments. They might diagnose a patient with a condition that is covered rather than the one the patient actually has. Reforming the health care system - and applying those reforms to entire populations - may do more to reduce health care costs than limiting services to Medicaid patients. The federal government, which is reviewing the Oregon plan, should urge the state to cover more services so that Medicaid patients will receive adequate health care.

Care and treatment, Medically uninsured persons, Oregon, Medicaid

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