|Title:||No evidence or no alternative? Taking responsibility for off-label prescribing|
|Citation:||Ghinea N, Lipworth W, Kerridge I, Day R. 2012. No evidence or no alternative? Taking responsibility for off-label prescribing. Internal Medicine Journal. 42(3): 247-251|
|Abstract:||Recombinant activated factor VII (rFVIIa) is registered for patients with rare haematological disorders, but is used"off-label" in many other situations, including intracranial haemorrhage, cardiac surgery, trauma, transplantation and prostatectomy. Lack of systematic evidence to support these off-label uses has not slowed the growth of off-label prescribing of rFVIIa. We use the case of rFVIIa to illustrate the issues raised by off-label prescribing, and the kind of impasse that can arise when views about evidence, expertise and clinical necessity are in conflict. We argue that clinicians, hospital drug committees and regulators all need to acknowledge the complexity of prescribing decisions, and ensure that decisions to prescribe off-label are sufficiently justified.|
|Type of Work:||Article|
|Type of Publication:||Post-print|
|Appears in Collections:||Research Papers and Publications. Sydney Health Ethics|
|NoEvidenceOrNoAlternative_PP-2012.pdf||305.32 kB||Adobe PDF|
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