# article



## trbell (Nov 1, 2000)

The Internet Cares for Its Own - The Great American Disease Now that the hype has lessened to crawl, the real values of the internet can emerge. One value is the communication of human caring beyond artificial boundaries. Thatquality was amply demonstrated in events surrounding a drug companyï¿½s decision towithdraw a drug from the market in the face of consumer need. I witnessed theseoccurences as a member of an internet self-help group for people who suffer from ibs (http://www.ibsgroup.org/). Within hours of the announcement accurate information wasavailable here for the over 5000 members, and shortly after that there was accurateinformation regarding courses of action, such as who to call to protest, who to call forinformation, and a place to grumble and gripe. All of this was accomplished in a warmand caring atmosphere with the minimal but helpful guidance of the bulletin boardï¿½smanager, Jeffrey Roberts. The dust has not settled and the issues brought up by the chain of events are far fromresolved, but the stage is set for some constructive action by the parties involved. Theamount of suffering alleviated is untold and if there is to be suffering it will not beendured alone. The amount of galloping misinformation harnessed and flying rumorsgrounded is beyond measure. I find myself writing in superlativespeak because in thisday and age events seem to snowball in the public, media, and internet worlds and all theissues are grounds for talk-show festivities forever and ever. But the issues affect realpeople and in this case the internet would seem to have reached the real people. Ibs (irritable bowel syndrome, spastic colon, functional gastrointestinal disorder, etc.)is a little known but quite common condition that affects up to 30% of the population tosome extent and in severe cases is temporarily or permanently disabling (after depressionit is the most common cause of missed absence from work). It is multi-faceted, hasmultiple causes, and is as yet poorly understood even though there have been recentadvances in this knowledge. These advances have been so recent and so rapid that thereis a chance that your medical dictionary is out-of-date on this issue. One of theseadvances has been in the area of new medications and this is the area that led to thecurrent crisis. Lotronex (see http://www.aboutibs.org/lotronex.html for constantlyupdated information as of 11/28/00) is a medication that was shown to be helpful for oneof the two contradictory major symptoms of ibs (diarrhea rather than constipation) andfor one of the two major sexes with symptoms (females rather than males). Lotronexwas released earlier this year and appears to have been helpful to many, so many in factthat hundreds and thousands have been calling every place they can think of to complainwhen it was withdrawn from the market on 11/28 by Glaxo rather than comply with whatthey thought to be impractical restrictions for safeguarding its use. Since it is a verypainful condition as I can attest, these calls and letters and emails were and are angry,frustrated, but not unwarranted. The withdrawal was abrupt from the patientsï¿½ anddoctorsï¿½ point of view and could have set of riots by the way the parties handled it, andstill might. But the very existence of the bulletin board (and others like it Iï¿½m surealthough they are not as big and possibly not as well run) was a major factor in quietingrumors, providing accurate and timely information to all, and channeling protests to theappropriate target. The major players involved in this fiasco were Glaxo(1-888-TALKOGLAXO), the FDA(http://www.fda.gov/cder/drug/infopage/lotronex/lotronex.htm), and the Public Citizen(http://www.citizen.org/email_us.htm) - even if Ralph Nader is not popular here atpresent. Stress is among the major causes of ibs, particularly stress which comes from a sourcethat canï¿½t be controlled, and this kind of stress is at epidemic level in America right now. I am rather loose in my terminolgy as I include as part of America the internet world but Ithink most of my comperes on the net would concur in laying the blame to a large extenton the US in this context. Ibs also is not strictly-speaking a problem in this country, but Iwould suggest that, at least as far as the stress component is concerned, it comes fromhere.RELAX, MEDITATE, DRAW, LAUGH, DONï¿½T OBSESS OVER THE ELECTION tom bell, PsyD2518 Wellington Pl.Murfreesboro, TN 37128615-904-2374 http://members.tripod.com/~trbell/metaphor/metapho.htm http://members.tripod.com/~trbell/lifedesigns/ http://members.tripod.com/~trbell/laugh/jokesibs.htm Subjects ADD -Read This 1stAyudar En Espaï¿½olDiagnose/Treatment- MedicationsLife with ADD- In Children- Adolescent- College & ADD- Adult ADD- Men with ADD- Women & ADD- Romance- SSI Benefits- ADHD Schools- ADHD Clinicians- ADD Coaches- Support GroupsADD+Other DisorderParenting Help- Family ImpactTeaching ADHD Kids- Special Ed- Gifted Ed- Dyslexia, LD's- AdvocacyAdvocates/AttorneyResearchBook ReviewsControversy- CriticismsSubject Library All articles on this topic Stay up-to-date!Subscribe to our newsletter. Do you like our sites?Wish to share them with others - and earn money?Become an Affiliate Got a question?Ask an Expert DIRECT-TO-CONSUMER PRESCRIPTION DRUG ADS GET POOR GRADES FOREDUCATING CONSUMERS Health policy experts suggest regulation may be needed Source: The Journal of Family Practice, 12-00(SACRAMENTO, Calif.) -- Proponents of consumer drug ads say the promotions domore than sell pills, they also help educate people about medical conditions andtreatments. But the controversial ads actually teach very little, according to a newanalysis by researchers at UC Davis and UCLA. The researchers call on drug companiesto voluntarily improve their advertising - or face regulation. The analysis andrecommendations appear in the December issue of The Journal of Family Practice. "No English-speaking country other than the United States permits direct-to-consumerprescription drug advertising," says Dr. Richard L. Kravitz, director of the UC DavisCenter for Health Services Research in Primary Care and a study author. "A leadingargument in favor of allowing this advertising is that the ads are educational; however,our research shows that in practice this argument often falls short." Also In This Feature ï¿½ Where you can find information about medicationsï¿½ Medications Used To Treat ADHD Dr. Kravitz and his co-authors scrutinized 320 print ads promoting 101 drug brands. Theads appeared in 18 popular magazines between 1989 and 1998. On an 11-point scale ofeducational content, the average ad scored only 3.2 points. Most ads failed to provide information about how a drug works, its success rate, howlong it must be taken, alternative treatments, or helpful lifestyle changes. A few ads didn'teven reveal the drug's name. Among the study's findings: 9 percent of the prescription drug ads reported the drug's success rate 9 percent helped to clarify misconceptions about the medical condition the drug isprescribed to treat 11 percent told how long the drug typically must be taken 12 percent talked about the condition's prevalence 20 percent revealed how long it takes for the drug to work 24 percent described lifestyle changes patients can make to improve the condition, eitheralone or with the drug 27 percent provided information about the condition's causes or risk factors 29 percent acknowledged the existence of one or more competing treatments 35 percent offered consumers a way to get more detailed printed or audiovisualinformation about the drug and condition 36 percent told how the drug works 60 percent described at least one symptom of the condition 73 percent provided a toll-free information number 95 percent named the medical condition "These ads are designed to encourage patients to request the advertised drugs fromphysicians," Dr. Kravitz says. "That can have three outcomes. The patient can request thedrug, and the drug can be appropriate, in which case the outcome is good. The patientcan request an inappropriate drug, and the doctor can acquiesce and prescribe it, whichcould cause the patient's health to suffer. Or the patient can request an inappropriatedrug, the doctor can refuse to prescribe it, and the patient and doctor can get locked in anargument that imperils the doctor-patient relationship." In their article, the authors offer suggestions for physicians in dealing with patientrequests. The article recommends that physicians keep on hand informational materialsproduced by such organizations as the American Academy of Family Physicians and theAmerican College of Physicians. Then, when a patient asks about an advertised drug, thephysician can provide a handout, saying, "This information is produced by the bestexperts in the field and provides a more balanced view than what you will find inprofit-motivated advertisements," the authors suggest. If the pharmaceutical industry does improve the educational content of its prescriptiondrug ads, further research will be needed to assess the impact of that change onphysician-patient interactions, the authors say. Among the questions to be asked: Do educational promotions increase demands bypatients for drugs that are not medically indicated, requiring time-consumingre-education by physicians? Or do better-informed patients take less time to treat andcounsel? For now, the authors argue that prescription drugs ads should provide better information."Providing complete and accurate information," they state, "is the right thing to do." "The medical community should exert pressure on the drug industry to incorporate moreinformation about conditions and treatments in its advertising... If such information is notprovided voluntarily by the industry in future advertising, the medical establishmentshould lobby for regulation," the article argues. tom bell


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