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What is associated with increased side effects and lower perceived efficacy following switching to a generic medicine? A New Zealand cross-sectional patient survey.

ABSTRACT: OBJECTIVE:Following a switch from either a generic or branded antidepressant (venlafaxine) to a new generic, we investigated the factors associated with a preference for branded medicines, side effects reported following switching and efficacy ratings of the new generic drug. DESIGN:A cross-sectional survey of patients switched to a new generic. SETTING:Patients accessing venlafaxine information online from the New Zealand government pharmaceuticals funding website. PARTICIPANTS:310 patients, comprising 205 originally on branded venlafaxine and 105 previously taking a generic version. MAIN OUTCOME MEASURES:An online questionnaire assessing demographic factors, perceived sensitivity to medicines, trust in pharmaceutical agencies, sources of switch information, preference for branded medicine, new medicine perceptions, side effects and efficacy ratings. RESULTS:Preference for branded medicine was significantly stronger in older patients (OR=1.04, 95%?CI 1.01 to 1.05), those taking branded venlafaxine (OR=2.02, 95%?CI 1.13 to 3.64) and patients with a higher perceived sensitivity to medicine (OR=1.23, 95%?CI 1.06 to 1.19). Different factors predicted side effects in those switching from the branded and those switching from the generic venlafaxine. Trust in pharmaceutical agencies and the number of side effects were significant predictors of efficacy ratings of the new generic in both patients switching from a branded and those switching from a generic version of venlafaxine. CONCLUSIONS:In patients switching from a branded medicine and those already taking a generic, different demographic and psychological factors are associated with preference for branded medicine, side effect reporting and perceived efficacy of the new drug. When switching to new generic, there appears to be a close bidirectional relationship between the experience of side effects and perceived drug efficacy. Trust in pharmaceutical agencies impacts directly on perceived efficacy and increasing such trust could reduce the nocebo response following a generic switch.

SUBMITTER: MacKrill K

PROVIDER: S-EPMC6196872 | biostudies-other | 2018 Oct

REPOSITORIES: biostudies-other

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What is associated with increased side effects and lower perceived efficacy following switching to a generic medicine? A New Zealand cross-sectional patient survey.

MacKrill Kate K Petrie Keith J KJ

BMJ open 20181018 10

<h4>Objective</h4>Following a switch from either a generic or branded antidepressant (venlafaxine) to a new generic, we investigated the factors associated with a preference for branded medicines, side effects reported following switching and efficacy ratings of the new generic drug.<h4>Design</h4>A cross-sectional survey of patients switched to a new generic.<h4>Setting</h4>Patients accessing venlafaxine information online from the New Zealand government pharmaceuticals funding website.<h4>Part ...[more]

PMID: 30341138

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Project description:The competence centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical education by offering training and mentoring programmes for residents, and by providing train-the-trainer and mentoring courses for supervisors. Beyond that, regional Residency Training Networks (RTN) on avoluntary basis were developed to facilitate structured and efficient clinical rotation programs. Primary aim was to investigate the burden of burnout and the development of professionalism among CCRTB-residencies within a cross-sectional study. Secondary aim was to evaluate differences between CCRTB-residents with and without participation in aregional RTN. Burnout was determined with the Maslach Burnout Inventory (MBI), comprising the scales emotional exhaustion, depersonalization, and personal accomplishment. Ambulatory professionalization was evaluated using the German Professional Scale (Pro-D), comprising the scales professionalism towards the patient, towards other professionals, towards society, and towards oneself. Statistical significance of group differences was calculated by nonparametric tests. Multivariable linear regression modelling was performed to estimate the independent impact of professionalization and RTN participation on burnout scores. 347 CRRTB residents in ambulatory postgraduate training were invited, 212 (61.1%) participated, and 197 (92.9%) were included in our analyses. Lower emotional exhaustion and depersonalization, and increased personal accomplishment was associated with increased professionalisation, which was significant for nearly all Pro-D scales (p ≤ 0.05). RTN residents showed higher professionalism towards the patient (p = 0.031), other professionals (p = 0.012), and towards the society (p = 0.007) than residents of unstructured programs, and higher levels of personal accomplishment (p < 0.05). Early and efficient professionalization might be akey to reduce burnout and to establish asatisfying career in family medicine. Train-the-trainer and mentoring concepts should be implemented regularly for the training of residents. Thus, increased engagement in medical didactics should be aprerequisite for accreditation as atraining practice for residents.

Project description:ObjectivesWe investigated associations of officially recorded crime and perceived neighbourhood safety with physical health, evaluating potential effect modification by gender.SettingNationally representative population-based survey in New Zealand.ParticipantsIndividual-level data from 6995 New Zealand General Social Survey (2010-2011) participants with complete data on physical health status, perceived neighbourhood safety, sociodemographic characteristics and smoking. Crime rate for each participant's home census was estimated based on data from the New Zealand Police (2008-2010).Primary outcome measureThe Transformed Physical Composite Score from the SF-12, a physical health summary score based on self-report ranging from 0 to 100.ResultsWe used cluster robust multivariable regression models to examine the associations among neighbourhood crime rates, perceived neighbourhood safety and the physical health summary score. Crime rates predicted adults' perception that it was unsafe to walk in their neighbourhood at night: for each additional crime per 100 000 residents adults were 1.9% more likely to perceive their neighbourhood as unsafe (95% CI 1.2% to 2.5%). While relatively uncommon, the rate of crime with a weapon strongly predicted perceived safety: for each additional crime per 100 000 residents in this category, adults were 12.9% more likely to report the neighbourhood as unsafe (95% CI 8.8% to 17.0%). Police-recorded violent and night crime rates were associated with worse physical health among women: for each additional crime per 100 000 residents in these category women had a 0.3 point lower physical health score (95% CIs -0.6 to -0.1 for violent crime and -0.5 to -0.1 for crime at night, gender interaction p values 0.08 and 0.01, respectively). Perceiving the neighbourhood as unsafe was independently associated with 1.0 point lower physical health score (95% CI -1.5 to -0.5).ConclusionsGender may modify the associations of officially recorded crime rates with physical health. Perceived neighbourhood safety was independently associated with physical health.

Project description:BACKGROUND:The gold standard management of aortic dissection, a life-threatening condition, includes multidisciplinary approaches. Although mental distress following aortic dissection is common, evidence-based psychosocial interventions for aortic dissection survivors are lacking. OBJECTIVE:The aim of this study is to identify the perceived psychosocial needs of aortic dissection survivors by surveying patients, their relatives, and health professionals to inform the development of such interventions. METHODS:This study used a cross-sectional survey and collected responses from 41 participants (27 patients with aortic dissection, 8 relatives of patients with aortic dissection, and 6 health professionals) on key topics, types of interventions, best timing, anticipated success, and the intended effects and side effects of psychosocial interventions after aortic dissection. RESULTS:The principal intervention topics were "changes in everyday life" (28/41, 68%, 95% CI 54.5%-82.9%), "anxiety" (25/41, 61%, 95% CI 46.2%-76.2%), "uncertainty" (24/41, 59%, 95% CI 42.9%-73.2%), "tension/distress" (24/41, 59%, 95% CI 43.9%-73.8%), and "trust in the body" (21/41, 51%, 95% CI 35.9%-67.5%). The most commonly indicated intervention types were "family/relative therapy" (21/41, 51%, 95% CI 35%-65.9%) and "anxiety treatment" (21/41, 51%, 95% CI 35%-67.5%). The most recommended intervention timing was "during inpatient rehabilitation" (26/41, 63%, 95% CI 47.6%-77.5%) followed by "shortly after inpatient rehabilitation" (20/41, 49%, 95% CI 32.4%-65%). More than 95% (39/41) of respondents anticipated a benefit from psychosocial interventions following aortic dissection dissection, expecting a probable improvement in 68.6% (95% CI 61.4%-76.2%) of aortic dissection survivors, a worse outcome for 5% (95% CI 2.9%-7.9%), and that 6% (95% CI 1.8%-10.4%) would have negative side effects due to such interventions. CONCLUSIONS:Our findings highlight a substantial need for psychosocial interventions in aortic dissection survivors and indicate that such interventions would be a success. They provide a basis for the development and evaluation of interventions as part of state-of-the-art aortic dissection management.

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Dataset Information

What is associated with increased side effects and lower perceived efficacy following switching to a generic medicine? A New Zealand cross-sectional patient survey.

Publications

What is associated with increased side effects and lower perceived efficacy following switching to a generic medicine? A New Zealand cross-sectional patient survey.

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