Drop in hormone therapy use shows doctors heed research findings.

2004 FEB 5 - (NewsRx.com & NewsRx.net) -- The dramatic drop in prescriptions for postmenopausal hormone replacement therapy after the risks of long-term estrogen/progestin use were announced suggests that physicians respond more readily to new clinical evidence than previously observed, say researchers at the Stanford University School of Medicine.

However, the researchers add that a study of the impact of hormone therapy findings, along with a separate analysis of a clinical trial involving a blood pressure medication, indicate that the physician response may be faster and more complete when the evidence is widely publicized through the news media and discussed by the general public.

Randall Stafford, MD, PhD, assistant professor of medicine at the Stanford Prevention Research Center and senior author of the two studies, said the findings suggest that consumers and the media play a pivotal role - one that is often overlooked by scientists - in establishing the pace at which clinical trial findings are translated into actions that improve public health.

"Our research provides reassurance that physicians will respond to new evidence," Stafford said. "Our work doesn't necessarily contradict past studies, which cast doubt on that process, but it illustrates the conditions under which physicians are most likely to respond. In particular, special circumstances may be required to engender the response that we observed."

The two studies appear in the Jan. 7 issue of the Journal of the American Medical Association.

Stafford said he and his colleagues wanted to examine whether evidence that a drug did more harm than good spurred physicians to change their practices. "In the ideal, medicine should be based on the most up-to-date clinical information that has solid evidence behind it," he said. "Yet past studies indicate that physicians don't necessarily switch their practices either completely or rapidly in response to new evidence."

For both studies, Stafford and his colleagues analyzed a national database to determine the number of prescriptions filled by pharmacies for the drugs in question. They also used a national survey of office-based physicians to determine the number of office visits at which the medications were either newly prescribed or continued. The combination of data helped them track changes in physician practice since the mid-1990s.