Recently, a patient of mine was hospitalized with lifethreatening renal failure, caused by a combination of alcohol abuse, non-steroidal antiinflammatory medication use and diabetes. She came to my office after discharge having started, on her own, using Aleve® for her osteoarthritis. This medication, not available over the counter in Canada, is heavily advertised in US media. It is a low dose of naproxen, a non-steroidal antiinflammatory, and was contraindicated in her case. Here, I thought, was a clear example of the negative effects of direct-to-consumer advertising (DTCA), which McLaughlin, Kaluzny, Kibbe and Tredway point to as an example of one of the key challenges facing primary-care physicians, in their fascinating article published in this issue.

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