Wednesday, September 07, 2005

Influence of Pharma on Medical Students

Medical students at risk for influence from pharmaceutical companies' marketing efforts, according to article in Medical News Today refering to a study published today in JAMA.

Medical Students’ Exposure to and Attitudes About Drug Company Interactions:
A National Survey (requires subscription)
Frederick S. Sierles; Amy C. Brodkey; Lynn M. Cleary; Frederick A. McCurdy; Matthew Mintz; Julia Frank; D. Joanne Lynn; Jason Chao; Bruce Z. Morgenstern; William Shore; John L. Woodard
JAMA, September 7, 2005; 294: 1034 - 1042.

Abstract:
Context:
While exposure to and attitudes about drug company interactions among residents have been studied extensively, relatively little is known about relationships between drug companies and medical students.
Objective:
To measure third-year medical students’ exposure to and attitudes about drug company interactions.
Design, Setting, and Participants:
In 2003, we distributed a 64-item anonymous survey to 1143 third-year students at 8 US medical schools, exploring their exposure and response to drug company interactions. The schools’ characteristics included a wide spectrum of ownership types, National Institutes of Health funding, and geographic locations. In 2005, we conducted a national survey of student affairs deans to measure the prevalence of school-wide policies on drug company–medical student interactions.
Main Outcome Measures:
Monthly frequency of students’ exposure to various activities and gifts during clerkships, and attitudes about receiving gifts.
Results:
Overall response rate was 826/1143 (72.3%), with range among schools of 30.9%-90.7%. Mean exposure for each student was 1 gift or sponsored activity per week. Of respondents, 762/818 (93.2%) were asked or required by a physician to attend at least 1 sponsored lunch. Regarding attitudes, 556/808 (68.8%) believed gifts would not influence their practices and 464/804 (57.7%) believed gifts would not affect colleagues’ practices. Of the students, 553/604 (80.3%) believed that they were entitled to gifts. Of 183 students who thought a gift valued at less than $50 was inappropriate, 158 (86.3%) had accepted one. The number of students who simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased was 452/758 (59.6%). Students at 1 school who had attended a seminar about drug company–physician relationships were no more likely than the nonattending classmates to show skepticism. Of the respondents, 704/822 (85.6%) did not know if their school had a policy on these relationships. In a national survey of student affairs deans, among the 99 who knew their policy status, only 10 (10.1%) reported having school-wide policies about these interactions.
Conclusions:
Student experiences and attitudes suggest that as a group they are at risk for unrecognized influence by marketing efforts. Research should focus on evaluating methods to limit these experiences and affect the development of students’ attitudes to ensure that physicians’ decisions are based solely on helping each patient achieve the greatest possible benefit.

Some things I found interesting:
Of respondents, 93.2 percent were asked or required by a physician to attend at least 1 sponsored lunch.
Nearly 60 percent (59.6 percent) of the students simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased. 85.6 percent did not know if their school had a policy on these relationships. In a national survey of student affairs deans, among the 99 who knew their policy status, only 10.1 percent reported having school-wide policies about these interactions.

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The Krafty Librarian has been a medical librarian since 1998. She is currently the medical librarian for a hospital system in Ohio. You can email her at: