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eLetters: Practice Guidelines are Overshadowed by Glossy Ads
In response to: The management of hypertension in Canada: a review of current guidelines, their shortcomings and implications for the future
Daniel Roth
Email: danroth@interchange.ubc.ca
Affiliation: Medical Student, University of British Columbia
Posted on: March 19, 2001
The authors who recently reviewed the barriers that inhibit the implementation of hypertension management guidelines in Canada (1) neglected to mention what might be one of the most important factors – the powerful influence of pharmaceutical manufacturers' marketing campaigns on physician practice patterns (2). Ironically, the 'freebie phenomenon' was addressed in an article in the ‘News' section of the same issue of CMAJ in which the review appeared (3). Flip through the pages of that particular issue and you will come across five glossy advertisements promoting ACE inhibitors or AT1 receptor blockers in the treatment of hypertension. Clinical practice guidelines (CPGs) are only reflected in the very tiny print at the bottom of such ads where it is written that the drug is indicated ‘when treatment with diuretics or beta-blockers is not appropriate.' If the groups that create CPGs are wondering how to more effectively influence physicians' practices across the country, perhaps they should take a lesson or two from the drug companies – give out lots of free drug samples and promotional items, host elaborate events where physicians are told about the excellent safety and tolerability profiles of the recommended drugs, and place glossy two-page ads throughout each issue of CMAJ. Apparently, it works.
References
1. McAlister FA. Campbell NRC, Zarnke K, Levine M, Graham ID. The management of hypertension in Canada: a review of current guidelines, their shortcomings, and implications for the future. CMAJ 2001; 164(4):517-22.
2. Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA 2000; 283(3):373-380.
3. Sibbald B. Doctors asked to take pledge to shun drug company freebies. CMAJ 2001; 164(4):531.
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