Web-based curriculum in rational prescribing wins geriatrics Educational Product of the Year Award

WINSTON-SALEM, 13 jan 2010 – "Principles of Rational Prescribing," a web-based lesson developed by faculty at Wake Forest University School of Medicine, was voted "Educational Product of the Year" recently among products developed by 40 academic geriatrics programs in the United States.

The designation was made at the national meeting of grantees of the Donald W. Reynolds Foundation, which funds comprehensive programs to strengthen physicians' training in geriatrics.

"Principles of Rational Prescribing" is part of the SmartPrescribe curriculum, developed at the School of Medicine to combat the influence that increasing drug company marketing can have on physician prescribing. The 30-minute interactive "Principles of Rational Prescribing" lesson is now also featured as the Editor's Choice on the curricular clearinghouse, Portal of Geriatrics Online Education (www.POGOe.org).

"There is a big concern now about drugs being over marketed, and with consumer marketing being so prevalent, sometimes brand-name drugs are being prescribed too often for conditions where there is not sufficient research to support that use," said Janice S. Lawlor, M.P.H., SmartPrescribe program coordinator at the School of Medicine.

"Older adults are particularly vulnerable to the effects of less than optimal prescribing, such as potentially inappropriate medications, avoidable interactions, and off-label prescribing of drugs," added Hal H. Atkinson, M.D., M.S. Atkinson co-developed the rational prescribing lesson with colleague Kaycee M. Sink, M.D., M.A.S. "Our interactive module provides case-based discussions, mini-lectures, and a drug interaction game that physicians, including those in practice for many years, have found effective."

In addition to the rational prescribing lesson, the SmartPrescribe curriculum includes lessons aimed at teaching clinicians about critically assessing clinical trial reports, the U.S. Food and Drug Administration's approval process for new drugs, marketing techniques used by drug companies, and avoiding and managing marketing influence in physician practice. Using videos, surveys, quizzes and slides, the overall SmartPrescribe program also breaks down the research on drug company marketing to educate users that:

• Drug companies spend more than $27 billion each year on marketing – and about $8,200 per physician each year on sales representative visits to practices.
• Many marketing efforts have been shown to directly influence how often some drugs are prescribed.
• The majority of off-label prescribing is for uses with little or no supporting scientific evidence.

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In addition to Lawlor, Atkinson and Sink, the Wake Forest team that developed SmartPrescribe includes principal investigator Curt D. Furberg, M.D., Ph.D., David L. Bowton, M.D., David P. Miller, M.D., and Roger T. Anderson, Ph.D., now a faculty member of Penn State College of Medicine.

The SmartPrescribe team received a grant to develop the lessons from the Attorney General Consumer and Prescriber Education Grant Program, funded by a multi-state settlement of consumer fraud claims involving Neurontin®. That drug received Food and Drug Administration approval for treating epilepsy but was marketed by the manufacturer for conditions including migraines and psychiatric disorders. It is illegal to market drugs for off-label uses.

The National Public Health Association also recently endorsed SmartPrescribe for use by its members.