This study examines changes over a 10-year period in consumer reports of communication with health care providers about direct-to-consumer advertised (DTCA) medications. Two rounds of survey data were collected in 2003 and 2012 using repeated cross-sectional procedures to examine consumer willingness to discuss DTCA medications, content and tone of those conversations, and attitudes about the advertisements. In total, 472 surveys were analyzed. Generally, we found physician-patient conversations, attitudes, and behaviors regarding DTCA have changed. Consumers in 2012 reported talking significantly less about the names of the advertised drug, comparing the advertised drug with their current medication, and sharing general information than consumers in 2003. Attitudes toward the advertisements were significantly more negative in 2012 compared to 2003. Of those who specifically asked for a prescription, the proportion of patients who received the prescription was significantly lower in 2012, despite research suggesting increased rates of prescriptions. These results are interpreted in light of previous research about the lack of research examining the actual communication between physicians and patients on this topic. Limitations of the study are provided along with directions for future research about DTCA and physician-patient communication.
Objectives
The storage, use and disposal of controlled drugs (CDs) in hospitals and other healthcare centres are governed by a combination of government legislation and local policy. In the UK, a running balance must be kept for Schedule 2 CDs and when discrepancies arise, they must be investigated and reconciled. Policies on acceptable discrepancies are varied and based on anecdotal evidence. This study was designed to simulate dosing and stock check procedures for oxycodone oral solution, as a sample CD solution, and evaluate where the volume losses that cause discrepancies could arise from.
Methods
Hypromellose solutions were formulated to simulate oxycodone commercial solutions. These were used to simulate dosing and stock check practices. Quantification of volume loss during simulated routine dosing and stock check of viscous oral CD formulations were performed in triplicate.
Key findings
Dosing with enteral syringes via a fitted rubber bung never resulted in volume loss. Volume loss was always observed during stock checks with no statistical difference between methods used.
Conclusions
The findings of this study support the following recommendations. Hospital pharmacy departments should provide oxycodone and other CD liquid formulation bottles pre-fitted with a bung and make sure personnel use enteral syringes that are compatible with the chosen adaptor and of the most appropriate size for the intended dose. Stock checks should be limited to the minimum required by law or local policy.
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