1
|
Gameiro GR, Gameiro GR, Silva RME, Guilloux AGA, Cassenote AJF, Scheffer MC. Physician's perceptions regarding the pharmaceutical industry: a Brazilian national study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231317. [PMID: 38775504 PMCID: PMC11111120 DOI: 10.1590/1806-9282.20231317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/19/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking. METHODS A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents. RESULTS Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions. CONCLUSION The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.
Collapse
Affiliation(s)
| | - Gustavo Rosa Gameiro
- Clínica de Olhos Norte do Paraná – Londrina (PR), Brazil
- Universidade de São Paulo, Faculty of Medicine, Medical Education Development Center – São Paulo (SP), Brazil
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Ophthalmology and Visual Sciences – São Paulo (SP), Brazil
| | - Renan Magalhães e Silva
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
| | - Aline Gil Alves Guilloux
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
| | | | - Mario César Scheffer
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
| |
Collapse
|
2
|
Grabitz P, Friedmann Z, Gepp S, Hess L, Specht L, Struck M, Tragert SK, Walther T, Klemperer D. Quantity and quality of conflict of interest policies at German medical schools: a cross-sectional study and survey. BMJ Open 2020; 10:e039782. [PMID: 32998930 PMCID: PMC7528426 DOI: 10.1136/bmjopen-2020-039782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany. DESIGN Cross-sectional study, survey of medical schools, standardised web search. SETTING Medical schools, Germany. PARTICIPANTS 38 German medical schools. INTERVENTIONS We collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools' dean's offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies. MAIN OUTCOMES AND MEASURES Presence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities. RESULTS We identified relevant policies for one medical school via the web search. The response rate of the deans' survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI. CONCLUSIONS Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go.
Collapse
Affiliation(s)
- Peter Grabitz
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
- QUEST Center for Transforming Biomedical Research, Berlin Institute of Health (BIH),Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Zoe Friedmann
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | - Sophie Gepp
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | - Leonard Hess
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | - Lisa Specht
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | - Maja Struck
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | | | - Tobias Walther
- Universities Allied for Essential Medicines Europe e.V, Berlin, Germany
| | - David Klemperer
- Faculty of Social and Health Sciences, Regensburg University of Applied Sciences, Regensburg, Germany
| |
Collapse
|
3
|
Abbas M, Pires D, Peters A, Morel CM, Hurst S, Holmes A, Saito H, Allegranzi B, Lucet JC, Zingg W, Harbarth S, Pittet D. Conflicts of interest in infection prevention and control research: no smoke without fire. A narrative review. Intensive Care Med 2018; 44:1679-1690. [PMID: 30206643 DOI: 10.1007/s00134-018-5361-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Abstract
Conflicts of interest (COIs) do occur in healthcare research, yet their impact on research in the field of infection prevention and control (IPC) is unknown. We conducted a narrative review aiming to identify examples of COIs in IPC research. In addition to well-known instances, we conducted PubMed and Google searches to identify and report case studies of COIs in IPC and antimicrobial resistance (AMR), which were chosen arbitrarily following consensus meetings, to illustrate different types of COIs. We also searched the Retraction Watch database and blog to systematically identify retracted IPC and/or infectious disease-related papers. Our review highlights COIs in academic research linked to ties between industry and physicians, journal editors, peer-reviewed journals' choice for publication, and guideline committees participants and authors. It explores how COIs can affect research and could be managed. We also present several selected case studies that involve (1) the chlorhexidine industry and how it has used marketing trials and key opinion leaders to promote off-label use of its products; (2) the copper industry and how reporting of its trials in IPC have furthered their agenda; (3) the influence of a company developing "closed infusion systems" for catheters and how this affects networks in low- and middle-income countries and guideline development; (4) potential perverse incentives hospitals may have in reporting healthcare-associated infection or AMR rates and how government intervention may restrict AMR research for fear of bad publicity and subsequent negative economic consequences. Finally, the analysis of reasons for the retraction of previously published papers highlights the fact that misconduct in research may have other motivations than financial gain, the most visible form of COIs. COIs occur in the field of research in general, and IPC and AMR are no exceptions. Their effects pervade all aspects of the research and publication processes. We believe that, in addition to improvements in management strategies of COIs, increased public funding should be available to decrease researchers' dependency on industry ties. Further research is needed on COIs and their management.
Collapse
Affiliation(s)
- Mohamed Abbas
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland.
| | - Daniela Pires
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland.,Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicine da Universidade de Lisboa, Lisbon, Portugal
| | - Alexandra Peters
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland
| | - Chantal M Morel
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland
| | - Samia Hurst
- Institute for Ethics, History, and the Humanities, University of Geneva Medical School, Geneva, Switzerland
| | - Alison Holmes
- Department of Infectious Diseases and the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - Hiroki Saito
- Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, 1211, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, 1211, Geneva, Switzerland
| | | | - Walter Zingg
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland
| |
Collapse
|
4
|
Filippiadou M, Kouvelas D, Garyfallos G, Tsakiridis I, Tzachanis D, Spachos D, Papazisis G. Exposure to the drug company marketing in Greece: Interactions and attitudes in a non-regulated environment for medical students. Ann Med Surg (Lond) 2017; 19:23-28. [PMID: 28603612 PMCID: PMC5454084 DOI: 10.1016/j.amsu.2017.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Medical students are targeted by the pharmaceutical industry and are exposed to their marketing strategies even in the preclinical years of study. The marketing strategies used by pharmaceutical companies with physicians are also applied to students, affecting their future prescribing behaviour, and include low-cost non-educational gifts, travel expenses and conferences registration fees. In Greece, there are no national or institutional regulations and guidelines concerning drug company-medical student interactions. This study is the first time this estimate has been made in Greece and assessed a) the interactions between pharmaceutical companies and medical students, and b) students' attitudes towards pharmaceutical marketing. METHODS A sampling of undergraduate medical students completed an anonymous, self-administered, web-based survey. The first part of the survey investigated the interaction between the students and pharmaceutical companies; the possible answers were the binomial variables 'yes' or 'no'. The second part assessed the students' opinions of pharmaceutical company marketing and the answer options were 'agree', 'don't know/don't answer' and 'disagree'. RESULTS The survey was completed by 412 undergraduate medical students (mean age 22 ± 2.2 years, 52.7% were women); the overall response rate was 58.9%. Although the majority did not consider accepting gifts and meals from drug companies as ethical, most of them (59%) had accepted meals and low-cost non-educational gifts, especially the clinical-level students. Further, 52,6% of the students did not believe that accepting gifts from pharmaceutical companies would affect their own prescription behaviour, whereas surprisingly they held the opposite opinion of their classmates. The vast majority (85.9%) agreed that sponsored lectures were biased in favour of a company's products; however, 47.6% agreed that promotional material is useful for learning about new medications and 34.5% believed that medical schools should allow drug company representatives to interact with students. CONCLUSION Our results suggest that medical students in Greece are notably exposed to pharmaceutical industry marketing and their conflicting answers demonstrate that they are inadequately prepared for this interaction. Interventions are needed so that students are prepared and able to manage these interactions critically.
Collapse
Affiliation(s)
- Magdalini Filippiadou
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
- 2nd University Department of Psychiatry, Psychiatric Hospital of Thessaloniki, Greece
| | - Dimitrios Kouvelas
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Garyfallos
- 2nd University Department of Psychiatry, Psychiatric Hospital of Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Tzachanis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dimitrios Spachos
- Department of Medical Physics, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| |
Collapse
|