Wednesday, August 17, 2011

Go To Be In The Know

Image found here

A reader recently sent this interesting question:
I was reading your blog today while completing a search for information on increased patient reactions -- GI, skin, etc -- to hydroxychloroquine vs. brand name plaquenil. I am currently in an appeals process with my insurance to obtain the brand over generic for this drug.  I was hoping that given your background and interest in sjogrens and other autoimmune topics, you might know of a journal article relating to this topic. I have seen lots of individuals blog in various areas about problems that they have had with the generic that are not a problem when their physician switches them to the brand. 
I was diagnosed with sjogrens about 9 months ago and was stable on Plaquenil. However, with the insurance not covering the brand, tried the generic and then suffered GI problems that were absent on the brand. Any suggestions of places to look for validated information would be greatly appreciated.
Great question.

Have you ever used an internet search engine to find answers to medical questions? Well, of course you - and I - have. It's a logical and an easy way to begin the search for those answers.  But we all know that for every reputable medical information source, there's at least ten other questionable sites.

It appears to me that the reader is looking for reputable studies that confirm or disprove her experience that the generic version of plaquenil caused increased GI side effects.

Here's some of my favorite go-to sites when I begin a scientific literature search. Keep in mind that these sites are written for medical professionals and the terminology reflects this. It's a good idea to print out a copy of any study information that you wish to discuss with your doctor, so that she/he can see the date, study authors, and journal that published the study, in addition to the study methods and conclusions. Your doctor will be able to help you correctly interpret the data presented in these studies.

ALWAYS discuss your concerns with your doctor, and never stop or start taking medications or supplements based on information from these studies without your health care provider's permission.

PubMed: US National Library of Medicine/National Institutes of Health: "PubMed comprises more than 21 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites."

Google Scholar: "Google Scholar provides a simple way to broadly search for scholarly literature. From one place, you can search across many disciplines and sources: articles, theses, books, abstracts and court opinions, from academic publishers, professional societies, online repositories, universities and other web sites. Google Scholar helps you find relevant work across the world of scholarly research."

The Rheumatologist: "An official publication of the ACR and ARHP serving rheumatologists and rheumatology health professionals."

For those of us looking for articles written specifically for  patients and families, these sites provide excellent information:

MedlinePlus: MedlinePlus is the National Institutes of Health's Web site for patients and their families and friends. Produced by the National Library of Medicine, it brings you information about diseases, conditions, and wellness issues in language you can understand. MedlinePlus offers reliable, up-to-date health information, anytime, anywhere, for free. You can use MedlinePlus to learn about the latest treatments, look up information on a drug or supplement, find out the meanings of words, or view medical videos or illustrations. You can also get links to the latest medical research on your topic or find out about clinical trials on a disease or condition."

Mayo Clinic: "More than 3,300 physicians, scientists and researchers from Mayo Clinic share their expertise to empower you to manage your health."

What are your favorite sites for health information?


sue said...

I have used the Mayo Clinic site. Also, the Sjogrens Society of Canada as well as The Sjogrens Syndrome Foundation.

ShEiLa said...

I used to go to WebMD all of the time... but I find myself at the Mayo Clinic more often than not. I feel I can trust their information.

I am anxious to look into some of the other sites you listed.


MrsSpock said...

I am a certified managed care nurse and worked pharmacy prior authorization for a few years. When it comes to approving brand name over generic, we would ask if the generic had been tried by at least 2 manufacturers, as the inactive ingredients would be different. You can ask your pharmacy to look back in the claims to see if you have tried more than one manufacturer. If you try another and still have GI symptoms, your insurance company may grant an authorization for the brand. You can call them and see if this would be acceptable. If this doesn't work, I would recommend the appeals process, as I saw a lot of denial overturned on appeal.