Medication Appropriate Use and Systematic Reviews with Dr. James Wright

James (Jim) Wright obtained his MD from the University of Alberta in 1968, his FRCP(C) in Internal Medicine in 1975 and his Ph.D. in Pharmacology from McGill University in 1976. He is a practicing specialist in Internal Medicine and Clinical Pharmacology. He is also Co-Managing Director of the Therapeutics Initiative, Editor-in-Chief of the Therapeutics Letter and Coordinating Editor of the Cochrane Hypertension Review Group. He sits on the Editorial Boards of PLoS One and the Cochrane Library.

Questions We Asked:
•How did you become involved with pharmacology and drug prescription?
•How would you define appropriate use?
•Does financial implications to the patient play into appropriate use?
•What do most physicians not know when they prescribe medications?
•How does overprescribing play into medical waste?
•Why is there a disconnect between systematic reviews and clinical guidelines?
•How does bias play into drug testing?
•How can we successfully collaborate with pharmaceutical companies without including bias into research?
•How do everyday clinicians decide how to treat patients based on guidelines vs systematic reviews?
•What makes a good systematic review?
•What advice do you have for trainees who want to do good for their patients?
•Book Suggestions?

Quotes and Ideas:
•Appropriate use of medications means that the benefits outweigh the harms of the medication
•Every time a patient takes a medication, they are reminded of their medical condition that needs treatment.
•Many psychiatric medications get onto market only due to short term medical trials, but many are prescribed for long term conditions.
•Leaders should push for non-industry funded trials that evaluate the long term effectiveness of medications.
•ALLHAT trial as an effectively run drug testing study 
•We don’t want a situation where marketing is the driving force and not research
•Choosing Wisely Campaign

Book Suggestions:
•Sickening by John Abramson
•Our Daily Meds by Melody Petersen
•Anatomy of an Epidemic by Robert Whitakers