Study: Media coverage may influence prescribing trends

Key takeaways:

• After a newspaper published an article on low-dose oral minoxidil to treat hair loss, prescriptions significantly increased.
• Even if no new findings are reported, media coverage alone may influence prescribing trends.

Media coverage of medications may influence prescribing trends even if no new findings are reported, according to the results of a research letter published in JAMA Network Open.

While previous research has suggested that media coverage of health-related news may be connected to changes in patient behaviors and clinician practices, Brianna M. Goodwin Cartwright, MS, a research data analyst at Truveta, a company that delivers electronic health record data, and colleagues wrote that evidence on the links between social media and these behaviors is limited.

To learn more, the researchers conducted a cross-sectional study to evaluate changes in prescribing for minoxidil after it received attention in the media and on social media. According to Cartwright and colleagues, The New York Times published an article August 18, 2022, that described “successful treatment experiences of several dermatologists” and the results of a small observational study with women who had hair loss and received low-dose oral rather than topical minoxidil.

For the cross-sectional study, the researchers identified adults in the Truveta database who were prescribed oral minoxidil from the beginning of 2021 through the end of 2022. They ultimately included deidentified data from 6,541 patients with first-time oral minoxidil prescriptions, 42% of whom were men and 65.2% of whom were white.

The researchers calculated the weekly rate of first-time oral minoxidil prescriptions for 2.5 mg and 5 mg tablets, conducting interrupted time-series analyses of weekly prescription rates while accounting for autocorrelation using an autoregressive, integrated moving-average model. They also compared oral minoxidil to first-time low-dose finasteride hair loss medication and antihypertensive medications, since minoxidil is an antihypertensive.

Cartwright and colleagues found that after The New York Times publication describing use of low-dose oral minoxidil to treat hair loss, “there was an immediate increase in prescribing” despite the fact that the article did not report any new findings or large-scale randomized evidence.

Of the 6,541 participants with first-time oral minoxidil prescriptions, 2,846 participants received prescriptions in the 7 months before. In the 5 months after publication, 3,695 individuals received prescriptions.

Eight weeks after the article’s publication, the weekly rate of first-time minoxidil prescriptions per 10,000 outpatient encounters was significantly higher than 8 weeks before publication: 0.9 prescriptions (95% CI, 0.8-1 prescriptions) vs. 0.5 prescriptions (95% CI, 0.4-0.6 prescriptions).

Men saw a 2.4-fold increase (P < .001) in prescriptions — 1.1 (95% CI, 0.9-1.3) vs. 0.5 (95% CI, 0.4-0.6) — and women saw a 1.7-fold increase (P < .001) — 0.8 (95% CI, 0.7-0.9) vs. 0.5 (95% CI, 0.4-0.6).

After the initial increase, the researchers wrote that prescriptions decreased overall and for men and women, but they did not observe similar increases in hypertension or first-time finasteride prescriptions.

“Our findings suggest that media coverage alone, even without new research or with limited evidence, may be associated with immediate changes in prescribing, although they may not be sustained,” Cartwright and colleagues wrote.

The researchers also wrote that “underlying factors associated with this change in prescription behavior from patients, doctors or both and differences between males and females are important to understand.

“Socioeconomic factors, such as access to health care and education and income levels, may be associated with individuals seeking low-dose oral minoxidil after article publication,” they concluded.