Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/48013
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Type: Journal article
Title: Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study
Author: Montgomery, B.
Mansfield, P.
Spurling, G.
Ward, A.
Citation: BMC Public Health, 2008; 8(1):WWW 1-WWW 7
Publisher: BioMed Central Ltd.
Issue Date: 2008
ISSN: 1471-2458
1471-2458
Statement of
Responsibility: 
Brett D Montgomery, Peter R Mansfield, Geoffrey K Spurling and Alison M Ward
Abstract: Background Antihypertensive medications are widely prescribed by doctors and heavily promoted by the pharmaceutical industry. Despite strong evidence of the effectiveness and cost-effectiveness of thiazide diuretics, trends in both promotion and prescription of antihypertensive drugs favour newer, less cost-effective agents. Observational evidence shows correlations between exposure to pharmaceutical promotion and less ideal prescribing. Our study therefore aimed to determine whether print advertisements for antihypertensive medications promote quality prescribing in hypertension. Methods We performed a cross-sectional study of 113 advertisements for antihypertensive drugs from 4 general practice-oriented Australian medical publications in 2004. Advertisements were evaluated using a quality checklist based on a review of hypertension management guidelines. Main outcome measures included: frequency with which antihypertensive classes were advertised, promotion of thiazide class drugs as first line agents, use of statistical claims in advertisements, mention of harms and prices in the advertisements, promotion of assessment and treatment of cardiovascular risk, promotion of lifestyle modification, and targeting of particular patient subgroups. Results Thiazides were the most frequently advertised drug class (48.7% of advertisements), but were largely promoted in combination preparations. The only thiazide advertised as a single agent was the most expensive, indapamide. No advertisement specifically promoted any thiazide as a better first-line drug. Statistics in the advertisements tended to be expressed in relative rather than absolute terms. Drug costs were often reported, but without cost comparisons between drugs. Adverse effects were usually reported but largely confined to the advertisements' small print. Other than mentioning drug interactions with alcohol and salt, no advertisements promoted lifestyle modification. Few advertisements (2.7%) promoted the assessment of cardiovascular risk. Conclusion Print advertisements for antihypertensive medications in Australia provide some, but not all, of the key messages required for guideline-concordant care. These results have implications for the regulation of drug advertising and the continuing education of doctors.
Keywords: Humans; Hypertension; Antihypertensive Agents; Cross-Sectional Studies; Family Practice; Advertising; Australia; Practice Guidelines as Topic; Drug Prescriptions; Practice Patterns, Physicians'
Rights: © 2008 Montgomery et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RMID: 0020080860
DOI: 10.1186/1471-2458-8-167
Appears in Collections:General Practice publications

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