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QUOTE
Emerging
issues regarding informed consent
Consumers calling hotline with concerns The
staff at the Food and Drug Administration's Center for Veterinary
Medicine has conducted a two-year review of consumer messages to
our adverse drug experience hotline. The review indicates increasing
concern by consumers about risk and benefit of commonly prescribed,
approved animal drugs.
The CVM established the hotline, (888) FDA-VETS,
in 1996 to receive calls about adverse experiences to approved animal
drugs. We expected many of these reports to come from practicing
veterinarians, but our review indicates that a majority of the calls
in the past few years have come from consumers, particularly dog
owners who find our link on the Internet.
The CVM considers the drug label the first source
of important facts for veterinarians. The label is the result of
considerable scientific regulatory review before CVM approves the
drug. It represents known safety and efficacy for any one drug.
The label also gives veterinarians important information about whether
the drug is suitable for the individual or subgroup within a species
of animal. Additionally, whenever manufacturers distribute a client
information sheet, this means that either the manufacturer or the
CVM wishes to convey more facts about safety or efficacy in lay
terms to pet owners.
The staff at CVM monitors and evaluates adverse
drug experience reports and complaints of inefficacy for approved
and unapproved, marketed products. For approved products, this evaluation
of postmarket safety and efficacy incorporates knowledge gained
from the premarket studies as well as from scrutiny of peer-reviewed
studies related to the drug, or the disease that the drug is intended
to cure or prevent.
From the hotline, we have learned that pet owners
increasingly rely on Internet sources for information when their
pets have problems. They have told us that, during their Internet
searches, they often find label information and client information
sheets.
Frequent comments from pet owners who contact
the CVM hotline include these:
They did not receive a client information sheet when one was available
for a drug that was prescribed for their pet.
The medication they received from their veterinarian was not dispensed
in the CVM-approved container but was broken into aliquots that
were taken home without the client information sheet or approved
label.
The veterinarian did not conduct or recommend blood testing before
and after prescribing the drug, even though baseline testing and/or
periodic monitoring was recommended on the label. Common examples
include heartworm products and nonsteroidal, anti-inflammatory drugs.
After reading client information sheets and labels on the Internet
about a drug prescribed for their pet, they discovered that their
pet may have fallen into a category of animal for which a precaution
or contraindication existed.
Given these findings, we have the following
reminders for practitioners:
Drugs that come with client information sheets are intended to be
dispensed in the manufacturer's container, with the sheets accompanying
the prescription.
Product precautions, contraindications, safety information, and
warnings should help identify animal patients that are not good
candidates for the medication.
Labels change—if you have a large inventory of a product with
a long shelf life, you may want to contact the manufacturer or CVM
to obtain the most recent label. A long shelf life makes it likely
that some of the product won't be dispensed in the near future.
Often, this information is also posted on pharmaceutical companies'
official Web sites.
If you have comments or questions about this
issue, contact Dr. Victoria Hampshire at (301) 827-0158, or VHampshi@CVM.FDA.GOV.
—Dr. Victoria Hampshire, Adverse Drug
Events Coordinator, Office of Surveillance and Compliance, FDA Center
for Veterinary Medicine
END QUOTE
This is a much needed update. I hope you will visit the web site,
print this, and make sure your veterinarian(s) is aware! Please
post this far and wide!
Thanks to Dr. Hampshire and the FDA CVM. |