A Canadian study published in the Annals of Internal Medicine suggests that about one third of new prescriptions (written by primary care physicians) are never filled. Over 15,000 patients were followed from 2006 to 2009. Prescription and patient characteristics were analyzed, though patients were not directly interviewed about their rationale for not filling their prescriptions. In short, patients were less likely to fill a prescription if the treatment was expensive, but certain ...

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You know those little packets of paper, folded over eight times, written in type that can’t possibly be seen? You’ve seen them glommed onto the side of stock bottles of medications, or shoved into the paper box alongside a tube of prescription ointment. That unreadable thing is the official “product information,” often called the “label,” required for every FDA-approved medication. It contains all sorts of information, including lists of 
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The shocking ingredient in natural medicine So you think your medicine is natural. Ever wonder what’s inside? A product can be labeled “natural” if the main ingredient is from an animal, plant, or mineral. Arsenic, horse urine, and cow brain are natural. But are they natural for you? Here are four drugs whose origins may surprise you. Insulin was discovered in 1922. Until the 1980s, all insulin was ...

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Research and development is critical to battling disease.  Now, more than ever, technology can rapidly impact a patient and their disease process in a very positive way.  The process of developing a new drug or device is expensive and can be very time consuming.  As government funding for projects continues to decline, more funding is coming from private sponsorship according to a recent New York Times piece. Another critical source of ...

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In March 2014, Zohydro ER (hydrocodone extended-release) was introduced to the market. Never in my medical lifetime do I recall a medication stirring such angst. Worries of mass overdoses, backdoor FDA conspiracies, and blatant disregard for the public well-being abound. Is there method to this madness? Zohydro ER is a pain pill that, when taken by mouth, is released slowly over twelve hours. The active ingredient, hydrocodone, is an opioid (i.e. narcotic) that’s been around for ...

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As physicians, we often write prescriptions for our patients. Where, when, and how patients fill their prescriptions are usually outside of our realm of expertise. But should we be more involved? On occasion, the cost of a medication and possible alternatives will be the subject of my conversation with a patient. I was surprised, however, when one of my patients complained about the price of an antidepressant that I had prescribed. ...

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Readers have contacted me about a recent study that links acetaminophen use in pregnancy to the later development of ADHD in children. Is Tylenol yet another thing pregnant women need to avoid? The study, titled “Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders” was published this month in JAMA Pediatrics. Dutch researchers looked at about 60,000 children born from 1996-2002. Their parents have been filling out questionnaires and ...

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The surprising way patients get drugs Tom is diabetic, asthmatic, and broke. He’s back for a checkup. “I take my metformin every morning with my grits,” he says, “but I don’t need no refill. I just got me some metformin XR.” “How did you get extended release? They’re super expensive.” “Well, my neighbor runs a tattoo shop. We live behind her store. Her doc switched her up to insulin, so ...

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When I was in medical school, our nutrition researchers taught us that vitamins didn't do much good and only made expensive urine (where the water soluble ones end up).  We did learn about the classic vitamin deficiencies like scurvy, beriberi, rickets, etc.  But the evidence that healthy people should take vitamins was marginal at best. Is our search for immortality the reason that we turn to the pill or potion?  Do ...

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The CDC’s report on the overuse of antibiotics raises concerns that the infectious disease community has been aware of for decades. Unfortunately, systemic action to address these concerns is hindered by misperceptions about antibiotic therapy: that it is safe, inexpensive, easy to prescribe, and that early administration is the best approach. At first blush, antibiotic therapy appears to be safe. But there can be dangerous complications to its use. Clostridium difficile, an ...

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