Canada lacks oversight on online medical information

[David Baxter PhD]

Canada lacks oversight on online medical information, study finds
by CAROLINE ALPHONSO, Globe and Mail
Wednesday, Feb. 23, 2011

Canada may have a state-run health-care system, but the federal government is noticeably reticent when it comes to providing medical information online.

Wikipedia entries or pharmaceutical company websites are almost always the top hits when Canadians Google the name of a brand or generic drug, while in the United States, Web surfers are directed to a profile of the drug from the government-run National Library of Medicine?s website.

At a time when Internet searches are common for any type of medical problem ? and when the medical credentials of Dr. Wikipedia are dubious at best ? the lack of federal government oversight on drug searches raises concerns about the accuracy of information Canadians are receiving.

?There?s estimates that thousands of Canadians suffer adverse drug reactions every year, and providing people with accurate information is fundamentally important,? said Michael Law, an assistant professor at the Centre for Health Services and Policy Research at the University of British Columbia. ?People are clearly using the Internet, so we should be interested in what type of information they?re finding.?

Prof. Law and his colleagues conducted searches of nearly 300 drugs, and their results, published online this week in the Annals of Pharmacotherapy, showed that Wikipedia turns up as the first search result about 85 per cent of the time when looking up the generic name of a drug. Industry websites crop up nearly 80 per cent of the time when searching the brand name.

Compare this to the U.S., where about three-quarters of the time Google searches yielded a drug synopsis from the NLM, which is a branch of the National Institutes of Health, the country?s medical research agency.

The main reason for this discrepancy is that the U.S. government struck a partnership with Google last year to display its results more prominently when residents are searching prescription drugs online.

In Canada, no such deal exists ? and researchers are encouraging federal regulators to step forward.

Tim Vail, spokesman for Federal Health Minister Leona Aglukkaq, said the government is hoping to address the issue within the next year as it looks to strengthen its online presence. He said Ottawa is looking at all options, including working with search engines like Google to make sure accurate information from Health Canada is more prominent for Canadians doing Web searches on prescription drugs, the next pandemic or any other health issue.

?We?re continuing to modify our website and look at ways that will improve searches for Canadians so that we will be more prominent in search engines when Canadians are looking for it,? Mr. Vail said. ?We do realize that we are a trusted name and a trusted brand among Canadians.?

Prof. Law described the online world for medical information as the ?Wild West? in terms of what Canadians can find. He said Wikipedia often omits certain information on drugs, and pharmaceutical companies could potentially leave out adverse side effects.

One pharmaceutical company defended its online presence. Pfizer, which makes the cholesterol drug Lipitor, said it provides up-to-date scientific information on its website. A company spokeswoman, however, did encourage Web surfers to check the source of their information and to always seek an opinion from health professionals ? a message echoed by Prof. Law.

?I would hope that our study would also make patients aware of the fact that the information they read online may be inaccurate or incomplete,? Prof. Law said. ?Patients should be sure to talk to their health-care professionals about information they might find online.?

 

[Retired]

pharmaceutical companies could potentially leave out adverse side effects.

I find that the information on medications found on the sites of pharmaceutical companies provide essentially the same information delivered to physicians, aside from studies supporting the use of their product, namely the product monograph. The product monograph is the official document describing the medication including the incidence of adverse reactions seen during human clinical trials, and is the information submitted to the Country's regulatory agency in order to gain approval.

Any other information about how any given medication performs is gleaned from respected and reputable medical journals, content of which is not usually available to non subscribers online, except for articles' abstracts.

Drug information posted on NIH sites generally refllects information contained in product monographs, as does the information posted on the better medical and drug information sites. It may be written in easier language for the lay person to understand, but is and should be basd on the product monograph.

In Canada, the public can access the Health Canada Drug Product Database that contains the database of Canadian product monographs.

The Canadian DPD is not particularly intuitive and is designed to be used by professionals who know what they are looking for. The actual query to the Drug Product Database is on the lower part of the page, titled Drug Product Database Online Query

It should be noted that Drug Product Monographs are scientific papers containing technical language and statistical information that needs to be understood in the context in which it is presented, that is adverse reactions as compared to placebo. Furthermore, adverse reactions themselves cannot be interpreted without understanding the context in which they occur in relation to the illness or disorder being treated, whether the inconvenience of a given adverse effect outweighs the therapeutic benefit of the medication, and if the adverse reaction actually diminishes over time.

These interpretations require some professional understanding of pharmacology and clinical applications of the medication, so well intentioned lay people trying to interpret a product monograph can unwittingly be misled by the raw data.

This is not to preclude anyone researching their illness or medication online, and to have access to documentation, but it should be recognized a clinician bases therapeutic decisions not only on raw scientific data, like that found in phsrmaceutical companies' literature, but also on his/her own clinical experience along with that of colleagues shared through conferences and through medical publications.

So although the internet can be a valuable resource for empowering us a informed patients, we still need to work in partnership with our own medical professionals in order to make the choices that are right for our own particular situation. That choice cannot be made by simply reading a product monograph.