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