Availability of prescription drugs for bipolar disorder at online pharmacies

Monteith, Scott; Glenn, Tasha; Bauer, Rita; Conell, Jörn; Bauer, Michael

doi:10.1016/j.jad.2015.12.043

Cited by 20 publications

(14 citation statements)

References 38 publications

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“…The survey did not address if patients visited sites in a language other than their native language or which specific websites were visited. The survey also did not address the use of problematic websites that encourage unwanted behaviors such as self-harm (Mitchell et al 2014), issues related to online purchase of prescription or illegal drugs (Monteith et al 2016; Orizio et al 2011), or the impacts of direct to consumer pharmaceutical advertising where applicable (Mackey et al 2015). …”

Section: Limitationsmentioning

confidence: 99%

Online information seeking by patients with bipolar disorder: results from an international multisite survey

Conell

Bauer

Glenn³

et al. 2016

Int J Bipolar Disord

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BackgroundInformation seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information.MethodsA 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data.Results976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor.ConclusionOnline information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.Electronic supplementary materialThe online version of this article (doi:10.1186/s40345-016-0058-0) contains supplementary material, which is available to authorized users.

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Section: Limitationsmentioning

confidence: 99%

Online information seeking by patients with bipolar disorder: results from an international multisite survey

Conell

Bauer

Glenn³

et al. 2016

Int J Bipolar Disord

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“…Supplements are commonly used by patients with bipolar disorder [96], but drug interactions with supplements, alcohol, food, smoking, and illegal drugs were not considered. Legal issues related to DDI [97] and the use of psychiatric drugs purchased online from rogue pharmacies were not discussed [98,99].…”

Section: Drugmentioning

confidence: 99%

Potential Drug interactions with Drugs used for Bipolar Disorder: A Comparison of 6 Drug Interaction Database Programs

Monteith

Glenn²,

Gitlin

et al. 2020

Pharmacopsychiatry

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Background Patients with bipolar disorder frequently experience polypharmacy, putting them at risk for clinically significant drug-drug interactions (DDI). Online drug interaction database programs are used to alert physicians, but there are no internationally recognized standards to define DDI. This study compared the category of potential DDI returned by 6 commercial drug interaction database programs for drug interaction pairs involving drugs commonly prescribed for bipolar disorder. Methods The category of potential DDI provided by 6 drug interaction database programs (3 subscription, 3 open access) was obtained for 125 drug interaction pairs. The pairs involved 103 drugs (38 psychiatric, 65 nonpsychiatric); 88 pairs included a psychiatric and nonpsychiatric drug; 37 pairs included 2 psychiatric drugs. Every pair contained at least 1 mood stabilizer or antidepressant. The category provided by 6 drug interaction database programs was compared using percent agreement and Fleiss kappa statistic of interrater reliability. Results For the 125 drug pairs, the overall percent agreement among the 6 drug interaction database programs was 60%; the Fleiss kappa agreement was slight. For drug interaction pairs with any category rating of severe (contraindicated), the kappa agreement was moderate. For drug interaction pairs with any category rating of major, the kappa agreement was slight. Conclusion There is poor agreement among drug interaction database programs for the category of potential DDI involving psychiatric drugs. Drug interaction database programs provide valuable information, but the lack of consistency should be recognized as a limitation. When assistance is needed, physicians should check more than 1 drug interaction database program.

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“…Drugs prescribed for psychiatric disorders are a leading class of drugs sold at rogue online pharmacies that do not require a prescription (Leontiadis et al 2013 ). Websites for many rogue pharmacies are professionally designed, contain false quality seals, and cannot be differentiated from legitimate pharmacies solely by appearance (Monteith et al 2016b ). About 1/3 of patients with mental illness take supplement products, which are often self-selected, purchased online, associated with false advertising claims and quality problems, and may interact with prescribed medications or other supplements (OIG 2012 ; Bauer et al 2015 ; Wu et al 2007 ; O’Connor 2015 ).…”

Section: Ethical Issuesmentioning

confidence: 99%

Ethical perspectives on recommending digital technology for patients with mental illness

Bauer

Glenn²,

Monteith

et al. 2017

Int J Bipolar Disord

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The digital revolution in medicine not only offers exciting new directions for the treatment of mental illness, but also presents challenges to patient privacy and security. Changes in medicine are part of the complex digital economy based on creating value from analysis of behavioral data acquired by the tracking of daily digital activities. Without an understanding of the digital economy, recommending the use of technology to patients with mental illness can inadvertently lead to harm. Behavioral data are sold in the secondary data market, combined with other data from many sources, and used in algorithms that automatically classify people. These classifications are used in commerce and government, may be discriminatory, and result in non-medical harm to patients with mental illness. There is also potential for medical harm related to poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps. The goal of this paper is to increase awareness and foster discussion of the new ethical issues. To maximize the potential of technology to help patients with mental illness, physicians need education about the digital economy, and patients need help understanding the appropriate use and limitations of online websites and smartphone apps.

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Availability of prescription drugs for bipolar disorder at online pharmacies

Cited by 20 publications

References 38 publications

Online information seeking by patients with bipolar disorder: results from an international multisite survey

Online information seeking by patients with bipolar disorder: results from an international multisite survey

Potential Drug interactions with Drugs used for Bipolar Disorder: A Comparison of 6 Drug Interaction Database Programs

Ethical perspectives on recommending digital technology for patients with mental illness

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