s. Relative to January-June 2002, prescriptions from January-June 2003 declined by 66 percent for Prempro and 33 percent for Premarin. Small increases were observed in vaginal formulations and in new prescriptions for low-dose Premarin. If prescription rates observed through July 2003 remain stable, a decline to 57 million prescriptions for 2003, similar to the rate in 1995, is projected," the authors write.

"This example shows effective information dissemination of scientific evidence and clinical guidelines to patients and physicians, which has resulted in prompt changes in clinical practice. In addition, the subsequent media cascade undoubtedly enhanced dissemination. Our findings support prior literature suggesting that physicians may rapidly abandon well-established therapies when studies demonstrate harm. Whether acting alone or with the involvement of physicians, patients also played a major role in the decline in hormone therapy use that we observed," the researchers write.

(JAMA. 2004; 291:47-53. Available post-embargo at JAMA.com)

Editor's Note: This study was supported by an institutional National Research Service Award funded by the National Heart, Lung, and Blood Institute and by a research grant from the Agency for Healthcare Research and Quality.

USE OF CERTAIN HYPERTENSION MEDICATION DECLINED FOLLOWING RELEASE OF TRIAL RESULTS

In the second article, Randall S. Stafford, M.D., Ph.D., of the Stanford Prevention Research Center, Stanford University, Stanford, Calif., and colleagues tracked trends in alpha-blocker prescriptions filled by retail pharmacies and reports of alpha-blocker use in patient encounters with office-based physicians from 1996-2002.

In spring 2000, significant changes in recommendations for alpha-blocker use occurred as a result of early, unfavorable results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart At
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Contact: Randall S. Stafford
650-724-2400
JAMA and Archives Journals
6-Jan-2004

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