Pharmaceutical Industry Representatives Research Articles

Low molecular weight heparins versus unfractionated heparin for acute coronary syndromes

Acute coronary syndromes (ACS) are an important source of morbidity and mortality. Despite weak evidence for the use of unfractionated heparin (UFH) for acute coronary syndromes it is considered an accepted treatment for unstable angina and non-ST segment elevation myocardial infarction (MI). However, evidence suggests low molecular weight heparins (LMWH) are safer and more effective than UFH in the treatment and prevention of other thrombotic disorders. To assess the effects of LMWH compared to UFH for acute coronary syndromes. We searched the Cochrane Controlled Trials Register (the Cochrane Library issue 4, 2000), MEDLINE (January 1966 to December 2000), EMBASE (1980 to December 2000) and CINAHL (1982 to December 2000) and reference lists of articles. Authors of all include studies and pharmaceutical industry representatives were contacted to determine if unpublished studies which met the inclusion criteria were available. Randomized controlled trials of subcutaneous LMWH versus intravenous UFH in people with acute coronary syndromes (unstable angina or non-ST segment elevation MI). Two reviewers independently assessed quality of studies. Data were extracted independently by two reviewers. Study authors were contacted to verify and clarify missing data. We identified 27 potentially relevant studies, 7 studies (11,092 participants) were included in this review. We found no evidence for difference in overall mortality between the groups treated with LMWH and UFH (RR = 1.0; 95% CI: 0.69, 1.44). Some pooled outcomes showed some evidence of heterogeneity, few of the pooled outcomes were statistically heterogeneous most were homogeneous. LMWH reduced the occurrence of MI (RR = 0.83; 95% CI: 0.70, 0.99) and the need for revascularization procedures (RR = 0.88; 95% CI: 0.82, 0.95). We found no evidence for difference in occurrence of recurrent angina (RR = 0.83; 95% CI: 0.68, 1.02), major bleeds (RR = 1.00; 95% CI: 0.80, 1.24) or minor bleeds (RR = 1.40; 95% CI: 0.66, 2.90). A decrease in the incidence of thrombocytopenia (RR = 0.64; 95% CI: 0.44, 0.94) was observed for patients given LMWH. From these results, 125 patients need to be treated with LMWH to prevent 1 additional MI and 50 patients need to be treated to prevent 1 revascularization procedure. Insufficient data exist to compare different types of LMWH. LMWH and UFH had similar risk of mortality, recurrent angina, and major or minor bleeding but LMWH had decreased risk of MI, revascularization and thrombocytopenia. New Trials with longer follow up are required.

Residents Want Education on Interacting With Drug Industry

Residents Want Education on Interacting With Drug Industry

"C" is for costs, and cancer, and conference: Highlights of the First European Conference on the Economics of Cancer

The first European conference on the economics of cancer was held in Brussels, Belgium on November 19-21, 1997. This international meeting was organized under the European Organization for Research and Treat ment of Cancer. Approximately 300 participants from around the world, including physicians, health care econ omists, epidemiologists, pharmaceutical industry repre sentatives, pharmacists, and other researchers, clinicians, and administrators attended the sessions. This interna tional mix of professions, along with the 12 plenary sessions, 4 tutorials, and over 100 contributed oral and poster presentations, made for a very interesting and informative conference. This review will focus on out comes measurement tools, pharmacoeconomics in clini cal trials, issues regarding the improvement of the quality and usability of pharmacoeconomic evaluations, and state of the art pharmacoeconomic reviews of hematopoietic growth factors and lung cancer. Abstracts of contributed presentations have already been published.1

Activities of Pharmaceutical Industry Representatives at a Major Teaching Hospital

Activities of Pharmaceutical Industry Representatives at a Major Teaching Hospital

Medication use and the elderly: current status and opportunities.

The crucial role played by medication use in the elderly is common knowledge in the worlds of health services research, clinical epidemiology, and geriatrics. It is now widely known that although persons over age sixty-five represent only about 13 percent of the population, they consume nearly one-third of all medications in the United States; that medications probably are the single most important health care technology in preventing illness, disability, and death in the geriatric population; that drugs represent one of the largest and fastest-rising out-of-pocket health care expenditures for the elderly; and that the old, because of their high drug usage rate, greater frequency of coexisting illnesses, and diminished physiological reserves, are at greater risk of experiencing adverse drug effects. Yet despite this knowledge, the use of drugs by the elderly and their clinical outcomes have not been prominent research or programmatic priorities for federal government, philanthropic, or corporate grantmakers. Beginning in the mid-1980s, The John A. Hartford Foundation began a grant-making program in the area of medication use and aging, out of an interest in enhancing the therapeutic effect of drugs used by this age group and in reducing the frequency and consequences of adverse drug events. After a number of years of active support in this area, the foundation convened its Expert Panel on Medications and Aging. This panel brought together authorities in the disciplines of geriatrics, gerontology, epidemiology, health services research, public policy, and pharmacology. Its mandate was to provide a consensus report that would critically define the further work needed to make the use of medications by the elderly more effective. This essay represents a synthesis of the work of that panel. The positions and opinions expressed below are extracted from transcripts of the expert panel’s deliberations, a structured survey administered to panel members,

Defining the Role of Pharmaceutical Industry Representatives

Defining the Role of Pharmaceutical Industry Representatives