ArticleDeutsches Arzteblatt international2014
Implementation of warnings from Dear Doctor Letters (Rote-Hand-Briefe): an analysis of medication data from a large cohort of elderly patients.
Article in Deutsches Arzteblatt international, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Mixed Impact of Direct Healthcare Professional Communications When Considering Proximal Outcomes and the Targeted Population: A Systematic Review.Pharmacoepidemiology and drug safety · 2025Pooled it
- Quality of Reporting on the Evaluation of Risk Minimization Programs: A Systematic Review.Drug safety · 2020Pooled it
- Measuring the impact of medicines regulatory interventions - Systematic review and methodological considerations.British journal of clinical pharmacology · 2018Pooled it
- Risk factors for QTc-prolongation: systematic review of the evidence.International journal of clinical pharmacy · 2017Pooled it
- Physicians' and pharmacists' perspective on clarity and clinical relevance of absolute contraindications in "Summaries of Product Characteristics".British journal of clinical pharmacology · 2025Article
- Dear Doctor Letters regarding citalopram and escitalopram: guidelines vs real-world data.European archives of psychiatry and clinical neuroscience · 2023Article
- [Effect of the direct healthcare professional communication on citalopram and escitalopram drug utilization for inpatient treatment of anxiety disorders].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2022Article
- Article
- Pharmacological treatment of major depressive disorder according to severity in psychiatric inpatients: results from the AMSP pharmacovigilance program from 2001-2017.Journal of neural transmission (Vienna, Austria : 1996) · 2022Article
- Impact of safety warnings for fluoroquinolones on prescribing behaviour. Results of a cohort study with outpatient routine data.Infection · 2021Article
- Article
- Comparative, cross-sectional study of the format, content and timing of medication safety letters issued in Canada, the USA and the UK.BMJ open · 2018Article
- Anticholinergic burden and cognitive function in a large German cohort of hospitalized geriatric patients.PloS one · 2017Article
- Medication and Treatment Adherence Following Hospital Discharge.Deutsches Arzteblatt international · 2016Article
- Comparison of old (75-79 years) to very old (80+ years) hospitalized otorhinolaryngology patients.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2016Article
- Co-Prescription of QT-Interval Prolonging Drugs: An Analysis in a Large Cohort of Geriatric Patients.PloS one · 2016Article
- Prescribing of long-acting beta-2-agonists/inhaled corticosteroids after the SMART trial.BMC pulmonary medicine · 2015Article
- Risk factors for falls and cognitive decline in older individuals.Deutsches Arzteblatt international · 2015Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDear Doctor Letters (also known as Direct Healthcare Professional Communications) inform physicians about significant newly discovered drug risks and about measures to take to reduce these risks. How far these warnings actually influence prescribing behavior is unclear.
methodThe Geriatrics in Bavaria-Database (GiB-DAT, Geriatrie in Bayern Datenbank) collects data from more than 50 centers offering inpatient geriatric health care. Based on GiB-DAT data, the discharge medication of 76 568 patients (81 ± 8 years, 67% women) was recorded in a standardized manner and analyzed for the implementation of information contained in two Dear Doctor Letters about the risks of dose-related or drug interaction-related QT interval prolongation caused by citalopram or escitalopram.
resultsPatients were discharged with a median of 8 drugs. In the four quarters of 2012 following release of the Dear Doctor Letters, in comparison to the four quarters before their publication, a marked drop from 9.8% to 4.1% was seen in prescriptions for >20 mg/day citalopram--a dosage no longer recommended in elderly patients--and a similar drop from 23.6% to 12.8% in prescriptions for >10 mg/day escitalopram (p<0.0001). Co-prescription of either of these two drugs with other QT interval-prolonging drugs, which was now contraindicated, remained almost unchanged (citalopram: 19.3% [95% confidence interval (CI): 17.9-20.9%] versus 18.4% [95% CI: 17.0-19.8%]; escitalopram: 17.6% [95% CI: 15.8-19.6%] versus 17.1% [95% CI: 14.5-19.9%]).
conclusionSimple information in Dear Doctor Letters, such as a reduction of the maximum daily dose, was better implemented than complicated information regarding contraindicated co-medication. Quality assurance systems such as the GiB-DAT network make it possible to identify problems of this kind. Licensing authorities and pharmaceutical companies should should improve the clinical usability, e.g., by providing official reference lists of drugs with safety warnings.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.