Thiazolidinediones and the influence of media adverse reporting on prescribing attitudes in practice (TZD-IMPACT) study

Prescribing behavior may be linked to media influence rather than to scientific evidence. Recently, the oral diabetic drug class of thiazolidinedione has been under the spotlight because of concerns over their cardiovascular safety. We have therefore conducted an electronic questionnaire survey among prescribing physicians in Tayside, Scotland to evaluate the prescribing attitudes and knowledge of the available evidence regarding the cardiovascular safety of thiazolidinedione use. Nationally representative prescribing data thoughout Scotland and Tayside from the IMS Health RSA dataset were also examined. Prescriptions for rosiglitazone alone or in combination with metformin have steadily decreased since the publication of a meta-analysis suggesting harm from rosiglitazone. This was mirrored by a gradual increase in prescriptions of pioglitazone. However, when questioned, the majority of doctors rate the level of information received regarding drug safety information on thiazolidinediones to be low with 68% of respondents scoring 5 or less (scale 1-10) on the level of information received. The source of information regarding drug safety warning was highly varied ranging from journals (21%), scientific meetings (19%) and the news media (15%). The findings of this study clearly show a need to disseminate reliable drug safety information more effectively to prescribers.