
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, November 15, 1994                   TAG: 9411150111
SECTION: NATL/INTL                    PAGE: A-4   EDITION: METRO 
SOURCE: Chicago Tribune
DATELINE: DALLAS                                  LENGTH: Medium

STUDY: DOCTORS ARE DRUG-IGNORANT

Disturbing evidence that many American doctors practice medicine in an ineffective, wasteful fashion was presented in several studies at the annual meeting Monday of the American Heart Association.

These doctors continue prescribing drugs to heart patients long after research disputes their effectiveness, and they ignore drugs that are proven effective, researchers from Harvard and Yale universities reported.

Also, a substantial number of doctors apparently order unneeded tests and keep patients hospitalized too long, driving up the costs of treating heart patients, other researchers reported.

The Harvard study found that many doctors seem to ignore medical findings when prescribing drugs for heart patients, said Dr. Elliott Antman, director of coronary care at Brigham and Women's Hospital in Boston.

Antman, an associate professor of medicine at Harvard, and colleagues looked at prescriptions written for nearly 1,700 heart attack patients in studies undertaken a decade apart.

Antman's analysis showed that after 10 years of research that indicated a class of drugs called beta blockers were effective in treating heart patients, community physicians in the early 1990s were prescribing these drugs only for about a third of their patients.

Even more disturbing, said Antman, was the use of drugs called channel blockers in the face of studies that showed their ineffectiveness and even potential harm.

In the early 1980s, about 5 percent of patients received the calcium channel blockers, but a decade later, about 50 percent of patients seen by community physicians received them.

``If physicians were influenced by the clinical trials between 1980 and 1990,'' Antman said, ``we would expect that heart attack patients would have been given medicines that have been shown to be helpful. ...

``It was as if all the clinical trials showing the benefits of these drugs did not exist.''

Drug company sales people who give biased information to physicians probably are responsible for the growing popularity of calcium blockers despite evidence that they aren't useful, he said.

Antman noted that specialists who practice at research hospitals had a much better record in prescribing appropriate drugs than did general physicians who provide routine care.

A similar study done by Yale University scientists at Bridgeport Hospital in Connecticut also found that doctors prescribed calcium channel blockers more often than beta blockers, despite clinical evidence favoring beta blockers.

by CNB