Editorial: Principles of ethical prescribing for self and others: hydroxychloroquine in the COVID-19 pandemic

Coombes, Ian; Markwell, Alex; Kubler, Paul; Redmond, Andrew; McGurk, Gordon; Roberts, Jason A.

doi:10.18773/austprescr.2020.030

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…The off-label use of HCQ in COVID-19 has presented various ethical dilemmas; using the fight against the pandemic as the most prominent all-justifying factor has led to undermining evidence-based decision making. 1 , 2 Following its widespread use for the treatment of COVID-19 in healthcare facilities around the world, the Infectious Diseases Society of America has recommended that HCQ only be used in the context of a clinical trial. 3 …”

Section: Introductionmentioning

confidence: 99%

Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine

Cifuentes

Callejo

Peláez

et al. 2021

Medicina Clínica (English Edition)

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Section: Introductionmentioning

confidence: 99%

Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine

Cifuentes

Callejo

Peláez

et al. 2021

Medicina Clínica (English Edition)

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“…La utilización en indicaciones fuera de ficha técnica de la HCQ en COVID-19 ha puesto sobre la mesa diferentes dilemas éticos; la lucha contra la pandemia como factor más prominente que todo lo justifica ha llevado a socavar la toma de decisiones basadas en la evidencia 1 , 2 . A raíz de su uso generalizado para el tratamiento de la COVID-19 en centros sanitarios en todo el mundo, la Sociedad Americana de Enfermedades Infecciosas ha recomendado que la HCQ solo sea usada en el contexto de un ensayo clínico 3 .…”

Section: Introductionunclassified

Incidencia de la COVID-19 en pacientes en tratamiento crónico con hidroxicloroquina

et al. 2021

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Objetivo Analizar la incidencia de la enfermedad del coronavirus 19 (COVID-19) en pacientes consumidores crónicos de hidroxicloroquina. Pacientes y métodos Estudio multicéntrico observacional retrospectivo transversal en Áreas de Salud de Castilla La-Mancha y distritos sanitarios de Andalucía. De los 4.451 participantes incluidos en el primer reclutamiento se seleccionaron 3.817 sujetos con datos válidos. La variable principal del estudio ha sido la presencia o ausencia de infección por la COVID-19 por diagnóstico clínico, serológico o por reacción en cadena de la polimerasa. Se registraron variables sociodemográficas, clínicas y tratamientos y comorbilidades concomitantes. Resultados Ciento sesenta y nueve (4,45%) pacientes presentaron infección por la COVID-19, de los cuales fallecieron 12 (7,1%) y 32 (18,9%) requirieron ingreso hospitalario. La enfermedad respiratoria previa se relacionó con la infección por la COVID-19 (p < 0,05). La maculopatía aparece en un 5,3% de los pacientes y está relacionada significativamente con la dosis de hidroxicloroquina consumida (p < 0,05). Conclusión No existe relación entre consumo crónico de hidroxicloroquina e incidencia de la COVID-19.

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“…This highlights the ethical questions about prescribing experimental treatments. 13 It is important to distinguish off-label from experimental prescribing.…”

mentioning

confidence: 99%

“…This highlights the ethical questions about prescribing experimental treatments. 13 It is important to distinguish off-label from experimental prescribing.Given the rate that the pandemic is evolving, the processes required to start a clinical trial may appear prolonged. However, these processes are necessary to develop a protocol, allocate resources and ensure patients are monitored to avoid treatment-related deaths.…”

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confidence: 99%

Editorial: COVID-19 and the quality use of medicines: evidence, risks and fads

Roberts¹,

Bennett²

2020

Aust Prescr

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COVID-19 and the quality use of medicines: evidence, risks and fads Some studies that have been popularised by the media have been uploaded to online preprint servers without the rigour of peer review. This may not be apparent from an abstract or media report so a high level of scepticism is required.A global survey of physicians in early April 2020 found that hydroxychloroquine and azithromycin were prescribed or seen to be prescribed by nearly 50% of respondents. However, only 38% perceived efficacy in COVID-19. 10 Some healthcare workers have prescribed hydroxychloroquine for themselves and their families. This represents extrapolation of the very low-quality evidence for treatment 11 to experimental use for prophylaxis. 12 The decision may have been their own, but it has been rumoured that some doctors were advised by their employer to self-prescribe hydroxychloroquine due to their increased risk of being infected by patients with COVID-19. This highlights the ethical questions about prescribing experimental treatments. 13 It is important to distinguish off-label from experimental prescribing.Given the rate that the pandemic is evolving, the processes required to start a clinical trial may appear prolonged. However, these processes are necessary to develop a protocol, allocate resources and ensure patients are monitored to avoid treatment-related deaths. An experimental treatment should only be prescribed after informed consent is obtained.

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Editorial: Principles of ethical prescribing for self and others: hydroxychloroquine in the COVID-19 pandemic

Cited by 6 publications

References 7 publications

Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine

Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine

Incidencia de la COVID-19 en pacientes en tratamiento crónico con hidroxicloroquina

Editorial: COVID-19 and the quality use of medicines: evidence, risks and fads

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