New research published in the April issue of Medical Care found that patients with chronic pain conditions who request specific medications were more likely to be prescribed those medications. In two experimental scenarios, the authors found that patient requests for a particular medication substantially affected physician prescribing decisions, despite the drawbacks of the requested medications. A physician's willingness to accede to a patient's medication request was not influenced by patient attributes, physician, or organizational factors.
In one scenario, an undiagnosed patient with symptoms indicating sciatica requested oxycodone or something to help with pain. In a second scenario, a patient with already diagnosed chronic knee osteoarthritis requested Celebrex or something to help with pain. With respect to the sciatica patients, 19.8% of those requesting oxycodone and 1% of those making no specific request would receive a prescription for oxycodone (P=.001). Of the patients with knee osteoarthritis, 53% of those requesting Celebrex and 24% of those not requesting it would receive a prescription for Celebrex (P=.001). Read a news story, with link to the journal abstract and article, here.