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Off-label prescribing often not supported by science

That's the conclusion of Off-label Prescribing Among Office-based Physicians, published in the May 8 edition of the Archives of Internal Medicine. The researchers " used nationally representative data from the 2001 IMS Health National Disease and Therapeutic Index (NDTI) to define prescribing patterns by diagnosis for 160 commonly prescribed drugs. Each reported drug-diagnosis combination was identified as Food and Drug Administration-approved, off-label with strong scientific support, or off-label with limited or no scientific support. Outcome measures included (1) the proportion of uses that were off-label and (2) the proportion of off-label uses supported by strong scientific evidence. Multivariate analyses were used to identify drug-specific characteristics predictive of increased off-label use."

What they found was, I thought, a little shocking: 73 percent of the off-label mentions had little or no scientific support. So where are they getting the idea to prescribe a drug off-label, one can't help but wonder. It certainly isn't coming from accredited, evidence-based CME.

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