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[e-drug] Article of interest

E-drug: Article of interest
---------------------------------------------

E druggers may want to look at an article in the latest issue of JAMA
entitled ?Physicians and the pharmaceutical industry: is a gift ever
just a gift?? The web site address to view the entire article is:
<jama.ama-assn.org/issues/v283n3/full/jrv90028.html>. Here is the
abstract:

Context
  Controversy exists over the fact that physicians have regular
  contact with the pharmaceutical industry and its sales
  representatives, who spend a large sum of money each year
  promoting to them by way of gifts, free meals, travel subsidies,
  sponsored teachings, and symposia.

Objective
  To identify the extent of and attitudes toward the relationship
  between physicians and the pharmaceutical industry and its
  representatives and its impact on the knowledge, attitudes, and
  behavior of physicians.

Data Sources
  A Medline search was conducted for English-language articles
  published from 1994 to present, with review of reference lists from
  retrieved articles; in addition, an Internet database was searched
  and 5 key informants were interviewed.

Study Selection
  A total of 538 studies that provided data on any of the study
  questions were targeted for retrieval, 29 of which were included in
  the analysis.

Data Extraction
  Data were extracted by 1 author. Articles using an analytic design
  were considered to be of higher methodological quality.

Data Synthesis
  Physician interactions with pharmaceutical representatives were
  generally endorsed, began in medical school, and continued at a
  rate of about 4 times per month. Meetings with pharmaceutical
  representatives were associated with requests by physicians for
  adding the drugs to the hospital formulary and changes in
  prescribing practice. Drug company sponsored continuing medical
  education (CME) preferentially highlighted the sponsor's drug(s)
  compared with other CME programs. Attending sponsored CME
  events and accepting funding for travel or lodging for educational
  symposia were associated with increased prescription rates of the
  sponsor's medication. Attending presentations given by
  pharmaceutical representative speakers was also associated with
  nonrational prescribing.

Conclusion
  The present extent of physician-industry interactions appears to
  affect prescribing and professional behavior and should be further
  addressed at the level of policy and education.

JAMA. 2000;283:373-380

Joel Lexchin MD
Townhouse #2--40 Cedar Crescent
Glenside, S.A. 5065
Australia
Tel:  +8 8338 0151
e mail: joel.lexchin@utoronto.ca

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