I'm always amazed when individuals 'reject' guidelines - they are, after all, only guidelines. They are prepared after extensive consultation with as many interested parties as possible and represent a consensus opinion. Dr Dixon, as a GP, is probably not used to using products off-label but it can be necessary in specialist practice to provide certain individuals with the best option for them. The statement that the guidelines 'encourage' off-label use is a misreading of these guidelines and begs the question - has he read them and what is the motivation for making the statement?
Posted by Duncan Stanford 18/12/2008 9:07:53 PM
Off-label prescribing is at times quite appropriate and should not be dismissed out of hand. Remember when imiquimod was only approved for genital warts, but often safely prescribed (with informed patient consent for off-label use) for superficial BCC? I do agree however that Imiquimod would be a treatment of desperation rather than a treatment of choice for nodular BCC!As for "consensus" positions, remember that primary care practitioners are a small minority of these clinical oncology working parties - and that primary care practitioners with particular expertise in the area of interest may not be representated at all....
Posted by Dr Jeffrey G Keir, Ballina 18/12/2008 11:41:48 PM
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Posted by Duncan Stanford 18/12/2008 9:07:53 PM
Posted by Dr Jeffrey G Keir, Ballina 18/12/2008 11:41:48 PM
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