Use Of Drug Samples Research Articles

Real-World Performance Benchmarks in the Reading Ability of Prescription Drug Labels by Community-Dwelling Older Adults

Background: Despite known recommendations regarding standards for print size and the intuitive importance of vision in reading prescription labels, the predictive nature of vision and prescription label readability remains largely undefined. Furthermore, while the importance of vision is recognized, various demographic factors associated with the ability to read prescription labels have not been fully elucidated. Objective: Describe relationships between visual acuity, point size, and readability of prescription labels and provide insight into demographic factors associated with prescription label readability. Methods: Cross-sectional examination of prescription label readability by older, community-dwelling adults. Subjects were evaluated as to demographics, visual acuity, and ability to read test instruments consisting of unaltered prescription label features of five medications dispensed by community pharmacies and two drug samples. Descriptive statistics in conjunction with a logit predictive model were employed for data analysis. Results: Instructions for medication use were most recognizable, identified and correctly read by 95.60% of the study cohort while directions for the use of drug samples were lowest (34.91%). Among prescription label features, auxiliary labels consistently demonstrated poor readability. Level of visual acuity was statistically related to the ability to read prescription labels while identifying prescription label components increased proportionally with point size. Race, gender, and history of a recent eye examination were statistically significant predictors of prescription label reading ability. Visual acuity alone was found to explain approximately 26% of the variablity in ability to read Rx labels. Conclusion: Visual acuity is predictive of the ability to access Rx label information and should be considered a modifiable variable for improving prescription label reading ability amenable by appropriate eye care and spectacle correction.

Drug sampling in dermatology

The use of drug samples in a dermatology clinic is controversial. Drug samples are associated with influencing physician prescribing patterns often toward costlier drugs, increasing health care costs, increasing waste, inducing potential conflicts of interest, and decreasing the quality of patient education. On the other hand, they have the potential to help those in financial need, to improve adherence and convenience, and to expose patients to better drugs. Although some academic centers have banned drug samples altogether, many academic and private practices continue to distribute drug samples. Given the controversy of the topic, physicians who wish to distribute drug samples must do so in an ethical manner. We believe, when handled properly, drug sampling can be used in an ethical manner.

Inventory of Drug Samples in a Health Care Institution

Few data exist on the presence of drug samples in health care facilities. Although the use of drug samples has potential benefits, this practice is also controversial, as it can contribute to non-optimal drug use. The objective of this study was to evaluate the inventory of drug samples in a health care institution and to determine compliance with existing policies and procedures. This descriptive observational study was conducted in a university hospital centre from October 18 to November 1, 2007. A standardized data collection form was used for a physical inventory, which was intended to identify all drug samples available in the institution. The following information was recorded: number of locations where drug samples were found, primary patient care activity performed at each location, number of storage areas in the location, type of storage, presence of a lock, location of the key (if a lock was present), medical specialty, number of physicians and nurses likely to use the samples, reasons given for handing out samples, presence of a designated person to manage the samples, physical inventory (i.e., various details for each distribution unit), and declaration of samples to the pharmacy department. The inventory was conducted by 2 research assistants during day shifts. A total of 84 locations were included in the inventory, and drug samples were found in 21 locations (with a total of 31 storage areas). All of the locations were intended for ambulatory patients (outpatient clinics and day centres). No drug samples were found in inpatient care units. The drug samples, which came from 62 different pharmaceutical companies, represented a total of 159 generic entities and 266 different brands. Of the distribution units for drug samples that were identified during this inventory, 59% were not on the hospital's local formulary. Furthermore, only 3.5% of the distribution units had been declared to the pharmacy department, in accordance with established policy. The sample distribution units, including expired units, totalled 78 955 doses, with a total value of Can$48 783 (based on unit prices in effect in October 2007). This study presents an inventory of drug samples in an urban health care institution and reports compliance with the institution's policies and procedures regarding drug samples. Samples were found only in outpatient clinics and represented 2.4 times the hospital's floor stock of medications. Most of the samples inventoried were not listed on the hospital's formulary. It appears that the use of drug samples is underestimated in hospital settings. Further studies are needed to evaluate the importance of drug samples and the risks associated with their use.

Patient Education and Counseling for Drug Samples Dispensed at Physicians' Offices

Pharmaceutical companies use free drug samples as an important marketing technique to promote prescription of their products at physicians’ offices. In 1999, more than 760 million samples were distributed by pharmaceutical representatives in the United States.1,2 Drug samples permit physicians to start treatment immediately and evaluate drug effectiveness for a short time without any cost to the patient. A prescription is usually given to the patient after a trial of introductory samples.3 However, sampling in this manner deprives patients of initial pharmacist screening and counseling about proper medication use, expected adverse effects, and interactions of the drug therapy.1,3 While the Joint Commission on Accreditation of Health Organizations requires institutions to have a policy and procedure regarding the handling, storage, and dispensing of drug samples,4 few regulations and requirements govern practitioners when dispensing or handling office drug samples. When a medication is dispensed from a pharmacy, a pharmacist checks the prescription order for proper dosing and indication, and screens the patient’s drug profile for potential drug duplications and interactions. The pharmacist counsels the patient about the proper use of the drug and answers queries.1,5,6 When a physician or nurse dispenses samples to patients, these steps may be omitted. Studies over the past few years have documented the effect of drug samples on physician prescribing habits, waste generation from drug sample packaging, increased drug costs with using drug samples, and the personal use of drug samples by health care professionals1,7–10 However, no published study describes or evaluates patient counseling on drug samples when physicians or nurses dispense them. Objective

Samples: to use or not to use?

The United States Prescription Drug Marketing Act makes people think that samples are simply advertisement for the drug companies. However, this is not the only reason that they are used. Samples make up a large part of most drug companies’ budgets and are used by many clinics with very little control. We need to ensure that these products are being used appropriately. This is becoming a big issue as reports suggest that over 90% of family practise residency clinics allow personal use of drug samples and 60% of pharmaceutical representatives have either used samples for themselves or have given them to non-physicians. The other disturbing fact is that despite the high use of samples, fewer than 10% of family practise residencies in a Brotzman and Mark study reported having written policies regarding the use of samples. The purpose of this article was to review the literature concerning the reasons for use of drug samples, and the problems associated with such use, and then to discuss possible procedures that offices, especially those that train resident physicians, can implement to ensure good governance, if such use is permitted.

Use of drug samples as a threat to seamless health care.

Use of drug samples as a threat to seamless health care.

Physician, heed thy shelf

One of the premises for physician-patient interaction is primum non nocere (first, do no harm), and this principle has been recently discussed regarding the use of drug samples.1,2 There have also been ethical challenges to sample use in our literature, and anecdotal reports of adverse irritant reactions to misuse of samples.3,4 In therapeutic decisions, the risk-benefit should be considered for each patient and treatment. In dermatology, this is particularly important in the choice of topical therapy or recommendations of over-the-counter products for abnormal skin, because the active ingredient (corticosteroid), the vehicle, or other ingredients could sting, burn, irritate, orsensitize.

Personal Use of Drug Samples by Physicians and Office Staff

To the Editor. —Dr Westfall and colleagues 1 raised ethical concerns regarding the frequent personal use of drug samples by medical personnel. We report on Clostridium difficile —related diarrhea as a complication of this practice in medical house staff who have ready access to pharmaceutical samples of antibiotics and frequent exposure to the organism in the hospital setting. A 26-year-old, otherwise healthy medical resident with self-diagnosed sinusitis began a course of amoxicillin-clavulanate samples that he had received from a pharmaceutical company representative. Ten days later he experienced crampy abdominal pain and watery diarrhea. He suspected C difficile —related diarrhea and empirically began a course of metronidazole until stool studies demonstrated C difficile by toxin assay (cultures for enteric pathogens were negative). His diarrhea responded to 10 days of oral metronidazole, but he experienced a relapse 4 weeks later that also responded promptly to re-treatment with the same regimen. A 28-year-old, otherwise

Risk of Hypoglycemia With Antihypertensive Medication-Reply

In Reply —We appreciate the interest in and comments about our recent article describing the personal use of drug samples by physicians and office staff. We are not surprised at the number or variety of responses or by the depth of emotion evoked. We applaud Dr Margolis' and Dr Rosner's reiteration of the ethical concerns raised in our article. We agree that there is a multitude of ethical dilemmas facing health care. However, as evidenced by the range of letters above, we believe the issues surrounding use of drug samples are important and deserve wide discussion and debate. We appreciate Rosner's broader discussion of other gifts from the pharmaceutical industry and feel this also deserves continued discussion. Dr Reynolds appears to have misunderstood our calculations. We reported a total of about $10 000 worth of drug samples taken for personal or family use. We attempted to minimize the discussion about dollar values

Personal Use of Drug Samples by Physicians and Office Staff

To Editor. —Dr Westfall and colleagues 1 consider personal use of drug samples by physicians and office staff to constitute substantial gift from pharmaceutical and that the ethical implications... warrant further debate. Gifts to physicians from pharmaceutical industry constitute a long-accepted tradition in complex relationships between drug companies and medical profession. Medical students are offered free books, free reflex hammers, free tuning forks, and a variety of other gifts. At medical conventions, physicians strolling through exhibition halls are able to obtain gratis dozens of different items from pens to key chains, from calculators to watches, from tennis balls to floppy disks, from fresh juices to espresso coffee, and on and on. 2 Should these gifts be considered to constitute a bribe? Are these gifts given freely by pharmaceutical industry with no ulterior motives? Although drug companies and biotechnology firms consider these gifts to be

Personal Use of Drug Samples by Physicians and Office Staff

To the Editor. —Dr Westfall and colleagues 1 seem to be in an unnecessary quandary over the ethical implications of the personal use of drug samples by physicians. The practice is unethical because it violates at least 3 duties of physicians. 2 The duty to do no harm— primum non nocere —is violated because samples raise the cost of care to patients, in that samples generate cost, ultimately paid for by patients, beyond the accepted cost of research, production, and marketing. Presumably patients have other uses for the resources that pay for physician samples. Another possible harm is through the possible improper use of medicines, as suggested by Westfall et al. The duty of fidelity—the obligation to serve the interests of the patient—is transgressed because the acceptance of samples for personal use makes the physician an agent of the pharmaceutical companies that provide them. The conflict of interest between serving

Personal Use of Drug Samples by Physicians and Office Staff

Personal Use of Drug Samples by Physicians and Office Staff

Personal Use of Drug Samples by Physicians and Office Staff

Personal Use of Drug Samples by Physicians and Office Staff

Personal use of drug samples by physicians and office staff

Personal use of drug samples by physicians and office staff

Personal Use of Drug Samples by Physicians and Office Staff

Pharmaceutical samples are commonly used in ambulatory care settings. There is limited research on their use or impact on health care providers and patients. To determine the extent of personal use of drug samples over a 1-year period by physicians and medical office staff. An anonymous cross-sectional survey of all physicians, resident physicians, nursing staff, and office staff in a family practice residency. Quantity of drug samples taken for personal or family use. Of 55 surveys issued, 53 (96%) were returned. A total of 230 separate drug samples were reported taken in amounts ranging from 1 dose to greater than 1 month's supply. Two respondents reported no use of drug samples, while 4 respondents reported taking more than 10 different samples. Drug samples are commonly taken by physicians and office staff for personal and family use. The ethical implications of this practice warrant further discussion.

Personal use of drug samples by physicians and office staff

Personal use of drug samples by physicians and office staff