ArticleCurrent therapeutic research, clinical and experimental2003
Reasons for overprescription of mononitrates: the paradigm of stable angina pectoris treatment.
Article in Current therapeutic research, clinical and experimental, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.
- Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOral nitrates, beta-blockers, and calcium channel blockers are used to treat stable angina pectoris (SAP). The 2 therapeutic subtypes of oral nitrates are mononitrates and dinitrates, with no evidence that 1 subtype is more efficacious than the other. Although practice guidelines in Great Britain and Israel recommend dinitrates as the first-line drug for SAP, in practice, many physicians in those 2 countries prescribe mononitrates.
objectiveThe aim of this study was to identify factors that influence specialist physicians (family practitioners, internists, and cardiologists) in Israel when prescribing nitrates for the prevention of SAP symptoms.
methodsA group of specialists was given a self-administered questionnaire regarding their treatment of choice for a patient with SAP described in a hypothetical case vignette. End points for prescribing preferences were evidence-based information, cost, and the influence of pharmaceutical company representatives.
resultsOne hundred ten specialists were given the questionnaire. Eighty-nine specialists (45 men, 44 women; mean age, 50.4 years; range, 34-67 years; response rate, 80.9%) completed it (39 family practitioners, 29 internists, and 21 cardiologists). Seventy-eight respondents (87.6%) chose to prescribe nitrates for the case vignette, and among those, 54 (69.2%) chose mononitrates and 24 (30.8%) chose dinitrates (P = 0.034). The choice of mononitrates over dinitrates was mainly affected by habit (25/54 [46.3%]) and the belief that mononitrates are more effective, safer, and/or less expensive than dinitrates (21/54 [38.9%]). Drug costs for the patient significantly influenced more family practitioners than hospital specialists (P<0.05).
conclusionsIn contrast to guideline recommendations, the paradigm of SAP treatment with nitrates in this study was characterized by significantly more prescriptions for mononitrates than dinitrates. This situation contributes to the erosion of the scarce resources of the health care system in Israel. Further efforts are needed to increase physicians' awareness of quality, cost, and choices when prescribing drugs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.