The goal of this study is to assess the knowledge and opinion of students regarding the off-label use of duloxetine in the treatment of SUI. The Survey questions were provided during the Drug Information Course at Howard University (HU) College of Pharmacy in a class where first-year pharmacy students learn how to conduct a literature search and a survey. A total of 39 students responded to the survey. There were more females (n=23; 56.1%) with an age range between 18 – 24 years. About two-thirds (n=29; 70.7%) had a four-year degree before starting the pharmacy program. Overall, participants scored less than the passing 70% mark on the knowledge questions, which may call for educators to make a special effort to incorporate off-label and approved indications of medication teaching therapeutic-related courses. For example, more than sixty percent of respondents (n=25; 61%) incorrectly stated that duloxetine is a narrow therapeutic drug. The majority (n=; 34; 82.9%) of the participants responded wrongly that urinary incontinence is more common in women during their childbearing age. The opinion survey showed that most participants (n=25; 61%) did not believe there were many FDA-approved effective drugs for treating UI. Over sixty percent of participants (n=25; 61%) considered UI a severe illness and did not agree to use a non-approved drug such as duloxetine, although several published clinical studies support its effective use. Participants were split in their opinion regarding the non-approved use of medications. Study results suggest that students may need encouragement to explore medications with non-FDA approvals.
1. Women’s bladder and bowel health conditions. National Association For Continence. 2022. Available from: https://nafc.org/womens-conditions/ (Accessed: January 18, 2023).
2. Lugo T, Riggs J. Stress Incontinence. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539769/
3. Sweeney DD, Chancellor MB. Treatment of stress urinary incontinence with duloxetine hydrochloride. Rev Urol. 2005;7(2):81-6.
4. Jost WH, Marsalek P. Duloxetine in the treatment of stress urinary incontinence. Ther Clin Risk Manag. 2005;1(4):259-64.
5. Norton PA, Zinner NR, Yalcin I, Bump RC. Duloxetine Urinary Incontinence Study Group. Duloxetine versus placebo in the treatment of stress urinary incontinence. Am J Obstet Gynecol. 2002;187(1):40-8. doi:10.1067/mob.2002.124840
6. Dmochowski RR, Miklos JR, Norton PA, Zinner NR, Yalcin I, Bump RC, et al. Duloxetine versus placebo for the treatment of North American women with stress urinary incontinence. J Urol. 2003;170(4 Pt 1):1259-63. doi:10.1097/01.ju.0000080708.87092.cc
7. Ghoniem GM, Van Leeuwen JS, Elser DM, Freeman RM, Zhao YD, Yalcin I, et al. A randomized controlled trial of duloxetine alone, pelvic floor muscle training alone, combined treatment and no active treatment in women with stress urinary incontinence. J Urol. 2005;173(5):1647-53.
8. Maund E, Guski LS, Gøtzsche PC. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports. CMAJ. 2017;189(5):E194-E203. doi:10.1503/cmaj.151104
9. Wittich CM, Burkle CM, Lanier WL. Ten common questions (and their answers) about off-label drug use. Mayo Clin Proc. 2012;87(10):982-90. doi:10.1016/j.mayocp.2012.04.017
10. Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians. Arch Intern Med. 2006;166(9):1021-6. doi:10.1001/archinte.166.9.1021
11. Chen H, Reeves JH, Fincham JE, Kennedy WK, Dorfman JH, Martin BC. Off-label use of antidepressant, anticonvulsant, and antipsychotic medications among Georgia Medicaid Medicaid enrollees in 2001. J Clin Psychiatry. 2006;67(6):972-82.
12. Kannan S, Bahl A, Khosla PP. Knowledge and perception of off-label drug use amongst prescribing physicians in a tertiary care hospital. Int J Risk Saf Med. 2015;27(4):219-23. doi:10.3233/JRS-150664
13. Mukattash TL, Alzoubi KH, Abuirjie AM, Jarab AS, Farha RK, Nusair MB, et al. Perceptions and attitudes towards off-label dispensing for pediatric patients, a study of hospital basedhospital-based pharmacists in Jordan. Saudi Pharm J. 2018;26(1):20-4. doi:10.1016/j.jsps.2017.11.004
14. AHRQ. Off-Label Drugs: What You Need to Know. Available from: https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html#:~:text=Off%2Dlabel%20prescribing%20is%20when,are%20for%20off%2Dlabel%20use. 2/8/2023
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