Do you ever get disillusioned with medicine? I do. Some days it seems I just hand out tablets and pills to people who probably don’t need them but ask for them by name based on TV ads. Pharmaceutical reps present costly new medications that treat problems already covered by cheaper generics. Then, there is the growing buzz about the dangers of unreported and skewed results of clinical trials, both surgical and pharmaceutical.
As nurse practitioners, part of our job, like it or not, is to sort through new these treatments and therapies determining their true efficacy. I wish research was straightforward, presented with pure intentions but it’s not. Medicine is a business. Companies are vying for you to prescribe their product and recommend their surgical devices selectively reporting research to their advantage. You must be able to analyze this information appropriately arriving at your own conclusions about clinical trial data.
When pharmaceutical reps arrive at your clinic with cookies and big glossy brochures or the New York Times reports on a new surgical technique, look past the glamour and hype. Here are some points to consider when looking at the latest medical research studies:
Sample Size– Whenever you look at a study, first check out how many people participated. If a study was done on four individuals it’s not reliable. 400? It deserves a little more credit. 4,000? Even better. The greater the number of participants in a study, the more reliable the results.
Length of the Study– Many medications have long-term side effects that are not initially captured in clinical research. The greater the length of a clinical trial, the more likely side effects are to appear. Always look at short-term clinical trial results with skepticism. Ask yourself, “what could the negative outcomes of this therapy be long-term?”. Studies that have taken place over the course of many years deserve more credit.
Subjects of the Experiment– Researchers like pure data. So, when testing their new drugs they look for clinical trial participants with few concurrent medical problems. This, however, is not reality. Whenever you review results of a research study, look at the individuals who participated. How do they compare to your typical patient population?
Side Effects– Every drug has side effects. Whenever you consider prescribing a new medication, you must consider the consequences. What negative effects could this medication have? How will these side effects impact your patient’s daily life? Based on research, how likely are these side effects to occur? Is the benefit worth the risk?
Is This Treatment Really New?– Many (or most) new drugs today are simply slight variations of already existing products. Have you noticed how many different types of steroid nasal sprays are available? Although pharmaceutical companies may claim their medication has a lower rate of side effects or is slightly safer, review this data to see if these claims are significant. It’s likely the generic medication that’s already out there will do the trick saving your patient money.
Still uncertain about the latest drugs? Ask. By formulating direct questions, you should be able to determine if a medication has undergone appropriate scrutiny. If something seems fishy, wait to prescribe.