Being an Informed Patient

From the New England Journal of Medicine. By Jerry Avorn, MD and Sebastian Schneeweiss, MD, ScD. SUMMARY: This NEJM Perspective by Avorn and Schneeweiss addresses the challenge of managing the growing volume of drug-risk data emerging from pharmacovigilance systems, post-market studies, and meta-analyses. The authors examine how clinicians and patients should interpret and act on the constant stream of new numbers — relative risks, absolute risks, number-needed-to-harm — gene

From the New England Journal of Medicine. By Jerry Avorn, MD. SUMMARY: This NEJM Perspective by Dr. Avorn examines the concealment of adverse drug effect evidence, using the Vioxx withdrawal and the FDA aprotinin (Trasylol) warning as central case studies. Avorn opens with the September 2004 Merck announcement that rofecoxib doubled the risk of myocardial infarction and stroke — leading to its withdrawal after five years of use in more than 20 million patients — and argues th

From the New England Journal of Medicine. By Jerry Avorn, MD. SUMMARY: In this NEJM Perspective written shortly after the January 2006 launch of Medicare Part D, Dr. Avorn characterizes the new benefit's implementation as chaotic and harmful to vulnerable patients. Drawing on Kaiser Family Foundation survey data, he documents widespread problems with the benefit's rollout, including pharmacy errors, coverage gaps, formulary confusion, and particular hardship for elderly patie

From New England Journal of Medicine. By Jerry Avorn. Abstract Improving precision and economy in the prescribing of drugs is a goal whose importance has increased with the proliferation of new and potent agents and with growing economic pressures to contain healthcare costs. We implemented an office-based physician education program to reduce the excessive use of three drug groups: cerebral and peripheral vasodilators, an oral cephalosporin, and propoxyphene. A four-state sa