Off-brand: A 6-year study of medication brand and generic name usage in a multifacility academic healthcare system.
Journal
Journal of hospital medicine
ISSN: 1553-5606
Titre abrégé: J Hosp Med
Pays: United States
ID NLM: 101271025
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
30
06
2023
received:
11
04
2023
accepted:
01
07
2023
medline:
4
9
2023
pubmed:
24
7
2023
entrez:
24
7
2023
Statut:
ppublish
Résumé
Usage of medication brand names in electronic health records may introduce conflicts of interest, perpetuate false perceptions of brand superiority, alter prescribing practices, and cause confusion leading to errors. We sought to identify the frequency of brand name medication usage in clinical documentation, as well as factors associated with increased usage. We conducted a retrospective analysis of all clinical documentation written at our healthcare system (a multifacility academic urban healthcare system) between 2015 and 2020. We used string-matching and regular expressions to identify medication mentions. We conducted bivariate analyses to identify associations between brand name usage and author-, note-, and medication-level factors, and a multivariate Poisson regression to clarify independent associations between individual factors and brand usage. A total of 104,456,653 notes from 37,285 unique authors were included in our analysis. A total of 162,906,009 medication mentions were identified, of which 36.0% were brand name mentions with a steady year-over-year decrease. Factors associated with the usage of a brand name include: author role, years since release, length and syllabic complexity of the generic name, service type, and encounter context. Over-the-counter availability did not affect usage. There was sizable individual variation between note writers.
Sections du résumé
BACKGROUND
Usage of medication brand names in electronic health records may introduce conflicts of interest, perpetuate false perceptions of brand superiority, alter prescribing practices, and cause confusion leading to errors.
OBJECTIVE
We sought to identify the frequency of brand name medication usage in clinical documentation, as well as factors associated with increased usage.
DESIGNS, SETTINGS, AND PARTICIPANTS
We conducted a retrospective analysis of all clinical documentation written at our healthcare system (a multifacility academic urban healthcare system) between 2015 and 2020.
MAIN OUTCOMES AND MEASURES
We used string-matching and regular expressions to identify medication mentions. We conducted bivariate analyses to identify associations between brand name usage and author-, note-, and medication-level factors, and a multivariate Poisson regression to clarify independent associations between individual factors and brand usage.
RESULTS
A total of 104,456,653 notes from 37,285 unique authors were included in our analysis. A total of 162,906,009 medication mentions were identified, of which 36.0% were brand name mentions with a steady year-over-year decrease. Factors associated with the usage of a brand name include: author role, years since release, length and syllabic complexity of the generic name, service type, and encounter context. Over-the-counter availability did not affect usage. There was sizable individual variation between note writers.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
812-821Informations de copyright
© 2023 Society of Hospital Medicine.
Références
Karet GB. How do drugs get named? AMA J Ethics. 2019;21:E686-E696.
Center for Drug Evaluation & Research. Best Practices in Developing Proprietary Names for Human Prescription. Center for Drug Evaluation & Research; 2020. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/best-practices-developing-proprietary-names-human-prescription-drug-products-guidance-industry
Greene JA. What's in a name? Generics and the persistence of the pharmaceutical brand in American medicine. J Hist Med Allied Sci. 2011;66:468-506.
Bronnenberg BJ, Dubé J-P, Gentzkow M, Shapiro JM. Do pharmacists buy Bayer? Informed shoppers and the brand premium. Q J Econ. 2015;130:1669-1726.
Dunne SS, Dunne CP. What do people really think of generic medicines? A systematic review and critical appraisal of literature on stakeholder perceptions of generic drugs. BMC Med. 2015;13:173.
Charan J, Saxena D, Chaudhri M, Dutta S, Kaur R, Bhardwaj P. Opinion of primary care physicians regarding prescription of generic drugs: a cross-sectional study. J Family Med Prim Care. 2021;10:1390-1398.
Gagne JJ, Choudhry NK, Kesselheim AS, et al. Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Ann Intern Med. 2014;161:400-407.
Desai RJ, Sarpatwari A, Dejene S, et al. Comparative effectiveness of generic and brand-name medication use: a database study of US health insurance claims. PLoS Med. 2019;16:e1002763.
Bryan R, Aronson JK, Williams A, Jordan S. The problem of look-alike, sound-alike name errors: drivers and solutions. Br J Clin Pharmacol. 2021;87:386-394.
Steinman MA, Chren M-M, Landefeld CS. What's in a name? Use of brand versus generic drug names in United States outpatient practice. J Gen Intern Med. 2007;22:645-648.
Ouyang D, Tisdale R, Cheng P, Chi J, Chen JH, Ashley E. What's in a name? Factors that influence the usage of generic versus trade names for cardiac medications among healthcare providers. Circ: Cardiovasc Qual Outcomes. 2018;11:e004704.
Ouyang D, Tisdale R, Ashley E, Chi J, Chen JH. Acetaminophen or tylenol? A retrospective analysis of medication digital communication practices. J Gen Intern Med. 2018;33:1218-1220.
Summers A, Ruderman C, Leung F-H, Slater M. Examining patterns in medication documentation of trade and generic names in an academic family practice training centre. BMC Med Educ. 2017;17:175.
Goddu AP, O'Conor KJ, O'Conor KJ, et al. Do words matter? Stigmatizing language and the transmission of bias in the medical record. J Gen Intern Med. 2018;33:685-691.
Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702-706. doi:10.1093/aje/kwh090
Office of the Commissioner. Statement on Continued Progress Enhancing Patient Access to High-Quality, Low-Cost Generic Drugs. Office of the Commissioner; 2019. https://www.fda.gov/news-events/press-announcements/statement-continued-progress-enhancing-patient-access-high-quality-low-cost-generic-drugs