Evidence from drug class reviews is often not accessible to practicing clinicians nor is it presented in a way that allows clinicians to use the information to guide treatment and prescribing decisions. Nevertheless, information from such reviews can be very helpful to clinicians as they evaluate the "evidence" provided to them through marketing strategies implemented, primarily, by the pharmaceutical industry and designed to influence their prescribing behavior. Unfortunately, these marketing strategies can be used to promote the off-label use of drugs that may not be efficacious. One example is the pharmaceutical marketing to promote off-label use of gabapentin (Neurontin) for the treatment of bipolar disorder, the legality of which was later addressed in a major lawsuit by the National Association of Attorneys General. We describe an effort to use counter-marketing strategies to compete with those implemented by the pharmaceutical industry and to help clinicians, principally psychiatrists, make use of available evidence to inform their prescription of antiepileptic drugs (AEDs) in the treatment of bipolar disorder. A growing body of literature describes industry marketing practices designed to influence prescriber behavior. This literature suggests that use of competing approaches involving the same underlying strategies to deliver highly credible information from trusted sources can inform prescriber knowledge and prescribing practice. We describe our use of existing evidence to develop accurate and convincing messages and materials to be disseminated nationally to counter industry misinformation and promote evidence-based prescription of AEDs.
MELVIN, RANNEY, and CAREY: Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill; EVANS: RTI International, Inc. Washington, DC.
The AED Dissemination Panel is composed of Cathy L. Melvin, PhD, MPH, W. Douglas Evans, PhD, Gary Kreps, PhD, Thomas Linden, MD, John Oldham, MD, MS, and Leah Ranney, PhD.
Please send correspondence and reprint requests to: Cathy L. Melvin, PhD, MPH, The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Boulevard, CB#7590, Chapel Hill, NC 27599-7590. email@example.com
Supported by a grant administered by the Vermont Office of the Attorney General and funded by a consortium of state attorneys general.