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According to the findings of a recent study, attorney advertisements appear to influence patients’ decisions on modifying or discontinuing their direct oral anticoagulant (DOAC) medication prior to seeking medical advice.
The aim of the study was to determine the impact attorney advertisements had on patients’ decisions surrounding their DOAC medications. “We searched the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) to identify US reports of patients who discontinued or reduced the dose of their DOACs (ie, dabigatran, rivaroxaban, apixaban, and edoxaban) after viewing an attorney advertisement, received by the FDA from approval of each DOAC through November 15, 2017,” the study authors explained. A total of 66 reports were identified in the search: 65 involving DOAC discontinuation, 1 involving DOAC dose reduction, and 7 deaths. Of the total cases, 97% (64/66) involved discontinuation of a DOAC prior to seeking medical advice.
Advertisements were classified into 3 categories. The first category included 25 reports that were considered “attorney” advertisements, which described a law firm advertisement. Of these reports, 72% (18/25) reported a negative consequence caused by discontinuation of a DOAC: stroke (N=13), thromboembolism (N=4), transient ischemic attack (TIA) (N=1), and death (N=3).
A total of 13 reports were classified into the second category, “1-800-BAD-DRUG” advertisements. The majority of these patients (11/13; 85%) experienced a negative consequence following medication discontinuation: stroke (N=8), thromboembolism (N=3), and death (N=2).
The last category included 28 “unspecified” advertisements, which did not have “enough information to classify the advertisement but that mentioned nonspecific terms such as negative television commercials.” Of these patients, 61% (17/28) experienced a negative consequence following DOAC discontinuation: stroke (N=12), thromboembolism (N=4), TIA (N=1), and death (N=2).
“Given the severity of the outcomes reported to the FDA, we believe that it is imperative for clinicians to counsel DOAC users about the risks of therapy modification in the absence of medical consultation,” the study authors concluded.
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