Schneider and a group of professors from the University Chicago has conducted an interesting study entitled "Perceptions of residents over time on interactions with the pharmaceutical industry, gifts and effects of an educational intervention." wanted to know if the perception of their relationships with the pharmaceutical industry go in the direction of approaching or moving away: a) over the years of residence in relation to their home and b) an educational program in the cohort starting in 2002 compared to the control that began in 2001. was conducted with residents in internal medicine at the University of Chicago Hospital (33 months), in an era that was in effect the "Opinion No. 8061 of the American Medical Association (AMA) ", which is home to the politics of interactions of this hospital. were anonymous surveys to provide more security to the truth, and it was rated on a scale of 1 to 4 (1: very inappropriate, 2: Inappropriate, 3: appropriate, and 4: very appropriate) in 17 items are "officially" considered about as appropriate and others as inappropriate. Clarify that the U.S. has increased pressure for interaction with doctors and health authorities lobby (lobby) of the world, so that neither the best case scenario is realistic to consider all the interactions as "inappropriate." However, industry is working effectively in and interact with medical students even in their own right. Not surprisingly, 86% of residents in this study acknowledged having sex with the drug before graduating. The study answers the following 17 items, divided into four sections: appropriate interactions: a) at a conference sponsored lunch at noon; b) exposure of the drug outside a conference at noon, c) brief discussion of the drug within a conference at noon; d) information and gits in the mailbox, e) information about products or gits in the work rooms; f) brochures on the walls of the work rooms. inappropriate interactions: a) sponsorship of informal food, b) sponsorship of dinners at the turn of emergency, c) calling on residents to discuss products. Gifts appropriate: a) pens, notebooks, guides antibiotics; b) textbooks. inappropriate gifts: a) organized tours; b) meals in private; c) dinners or drinks (or coffee cups), d) sports tickets, e) round of golf; f) travel and / or payment for signing up a national conference.
The researchers started from the assumption that residents would decline all or most 17 items, including that the opinion had been considering "appropriate" over his residence. And even more than expected decline in the educational intervention group, because it was: a) raise awareness of conflict of interest, showing the results of reviews of the interaction and conflicts of interest, guides, videos and memories of hospital policy; b) an outline of skills for critical analysis of the evidence (was used for COX-2) and to mitigate the interaction and the acceptance of gifts. Results: Only statistically significant decreases (weak) two of the first items "appropriate", namely "a conference sponsored meal at noon" and "short talk from drug within a conference at noon."
In the group receiving the educational intervention, only dropped the item "at a conference sponsored meal at noon, but no more, although the researchers expected.
The researchers said the study's limitations, among which should be highlighted that residents are strongly influenced by his teaching experience, models of the "role of resident" and its links with industry Pre-intervention (because they tended to have several, which are more likely to become "appropriate"). For example, residents who work with a teacher assistant who is often invited by the industry to give lectures or dinners can be influenced and consider both as "appropriate."
The researchers recommend starting this training since the beginning of school (going to the continuous reinforcement) and, among graduates, training and continuing education with the results of evidence on the interaction and conflict of interest, as well as dissemination of the policies of the AMA's opinion.
For Galo Sanchez
Posted by Antonio Villafaina
on Tuesday, April 20, 2010
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