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Failing at prescribing the best heart-failure treatments

stafford-pharm.jpgMost of us put a great deal of faith in the medications that our physicians prescribe for us, believing that our doctor is adhering to medical guidelines in deciding which pill will best treat our illness. But that isn't always the case.

Randall Stafford, MD, PhD, associate professor of medicine at the Stanford Prevention Research Center, has spent several years studying how well doctors change their practices to response to clinical trial evidence and to new medical guidelines. What he's found is that doctors are often slow to adapt.

His latest such findings appear today in the Archives of Internal Medicine. Stafford and his colleague, Dipanjan Banerjee, MD, tracked the types of medications that physicians are prescribing for a condition known as congestive heart failure. They found that the use of two types of drug therapy - both of which have proven highly effective in treating the disease - has steadily declined since the early and mid-2000s.

“Our expectation was that there would be continued improvement in the use of these drugs, but that hasn’t happened,” Stafford said. “We’re not sure what’s gone wrong.”

It's a good reminder that patients should seek out information about the therapies recommended by reputable sources (such as guidelines from medical societies) for conditions that affect them. In some cases, there may be legitimate reasons for prescribing alternate therapies - for instance, the recommended medication may have side effects that would be particularly bad for certain patients. But the dialogue between patient and physician is always important.

More information about the heart-failure study is available in this news release.

Photo by Steve Fisch

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