UBC Reports | Vol. 47 | No. 20 | December 13, 2001

Group to probe efficacy of commonly prescribed drugs

Studies underway include effectiveness of birth control access programs and smoking cessation pills

Closely controlled clinical trials may be just the beginning when it comes to determining drug effectiveness, say members of a new research group in UBC's Faculty of Pharmaceutical Sciences.

Called Collaboration for Outcomes Research and Evaluation (CORxE ), the group aims to improve the outcomes of drug therapy.

"Surprisingly, there is little known about the true effectiveness of many commonly used pharmaceuticals," says Prof. David Fielding, CORxE director." A drug can be seen to work in controlled clinical trials but when used by a diverse patient population, the result can be quite different."

In addition to improving outcomes, the researchers seek to inform economic evaluation and government policy related to pharmaceuticals.

Asst. Prof. Elan Paluck is a CORxE coordinator studying the effectiveness of bupropion.

Marketed as Zyban, the drug is used to treat smoking cessation and has been available in Canada since 1998. Wellbutrin SR, which also contains bupropion, is intended for use in treating depression but is also being prescribed as an aid to quitting smoking.

Health Canada has received more than 1,100 reports concerning bupropion's suspected adverse side effects which can include headache, skin rash, hallucination and seizures, according to Paluck.

In what she believes is the only such study in Canada, Paluck is working with a network of 50 B.C. community pharmacists over the next five months to recruit 450 people who are using bupropion to quit smoking.

Individuals will be contacted at one, three, six and 12-month intervals to check on effectiveness and adverse reactions. A hotline will be set up to receive reports of symptoms and people with side effects will be directed to their doctor.

Results of the study will be distributed to Health Canada, the provincial ministry of health, participating pharmacists and others.

CORxE coordinator Judith Soon is working with a team that includes representatives of government and advocacy groups to study use of the emergency contraceptive pill (ECP).

Last December, B.C. became the first province to authorize pharmacists to provide ECPs without a doctor's prescription.

In 1999 in B.C. more than 14,000 unwanted pregnancies were terminated with an abortion which represented 23 per cent of all pregnancies in the province, according to the provincial vital statistics office.

Almost 2,900 pharmacist-initiated ECP prescriptions in B.C. were dispensed in the first six months of the increased access program. About 50 per cent of women requested the drug due to failure of their regular birth control. Frequency of use is highest among 20- to 29-year-olds.

The CORxE study will evaluate the impact of the expanded access program on the prevalence and patterns of ECP use in B.C. from 1995-2002. Rates of pregnancy, abortion and sexually transmitted disease will also be examined.

Researchers will use data from the interlinked HealthNet databases that record drug dispensing and medical information from pharmacies, hospitals and doctors' offices.

"Very few jurisdictions in Canada can generate information on this scale," says Soon, an assistant professor who joined the faculty last year.

Other current CORxE members are: Assoc. Prof. Bruce Carleton, Prof. Mary Ensom, Prof. Marc Levine and Assoc. Prof. James McCormack.