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Medical students' exposure to and attitudes about the pharmaceutical industry: a systematic review.

Austad KE, Avorn J, Kesselheim AS - PLoS Med. (2011)

Bottom Line: We found that 40%-100% of medical students reported interacting with the pharmaceutical industry.Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism about negative implications of these interactions.Please see later in the article for the Editors' Summary.

View Article: PubMed Central - PubMed

Affiliation: Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.

ABSTRACT

Background: The relationship between health professionals and the pharmaceutical industry has become a source of controversy. Physicians' attitudes towards the industry can form early in their careers, but little is known about this key stage of development.

Methods and findings: We performed a systematic review reported according to PRISMA guidelines to determine the frequency and nature of medical students' exposure to the drug industry, as well as students' attitudes concerning pharmaceutical policy issues. We searched MEDLINE, EMBASE, Web of Science, and ERIC from the earliest available dates through May 2010, as well as bibliographies of selected studies. We sought original studies that reported quantitative or qualitative data about medical students' exposure to pharmaceutical marketing, their attitudes about marketing practices, relationships with industry, and related pharmaceutical policy issues. Studies were separated, where possible, into those that addressed preclinical versus clinical training, and were quality rated using a standard methodology. Thirty-two studies met inclusion criteria. We found that 40%-100% of medical students reported interacting with the pharmaceutical industry. A substantial proportion of students (13%-69%) were reported as believing that gifts from industry influence prescribing. Eight studies reported a correlation between frequency of contact and favorable attitudes toward industry interactions. Students were more approving of gifts to physicians or medical students than to government officials. Certain attitudes appeared to change during medical school, though a time trend was not performed; for example, clinical students (53%-71%) were more likely than preclinical students (29%-62%) to report that promotional information helps educate about new drugs.

Conclusions: Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism about negative implications of these interactions. These results support future research into the association between exposure and attitudes, as well as any modifiable factors that contribute to attitudinal changes during medical education. Please see later in the article for the Editors' Summary.

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PRISMA schematic of systematic review search process.
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pmed-1001037-g001: PRISMA schematic of systematic review search process.

Mentions: Our search strategy produced 1,603 abstracts. We identified 48 articles for full review and confirmed 33 [30]–[62] as eligible for analysis (Figure 1) [63]. Two papers [46],[47] reported overlapping data from the same sample of students, so we combined them for an effective total of 32 studies. The vast majority of studies (29/32, 91%) [30]–[32],[34]–[36],[38]–[39],[41]–[62] used a cross-sectional survey as the primary methodology, occasionally supplemented with other techniques, such as informant interviews [54] and analyses of student journals [30]. The remaining study designs included a practical exam [33], a case study [40], and a randomized experiment [37]. In total, studies assessed approximately 9,850 medical students at 76 medical schools or hospitals (one study [49] did not specify participants' school affiliation). All studies reviewed are listed in Table 1.


Medical students' exposure to and attitudes about the pharmaceutical industry: a systematic review.

Austad KE, Avorn J, Kesselheim AS - PLoS Med. (2011)

PRISMA schematic of systematic review search process.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3101205&req=5

pmed-1001037-g001: PRISMA schematic of systematic review search process.
Mentions: Our search strategy produced 1,603 abstracts. We identified 48 articles for full review and confirmed 33 [30]–[62] as eligible for analysis (Figure 1) [63]. Two papers [46],[47] reported overlapping data from the same sample of students, so we combined them for an effective total of 32 studies. The vast majority of studies (29/32, 91%) [30]–[32],[34]–[36],[38]–[39],[41]–[62] used a cross-sectional survey as the primary methodology, occasionally supplemented with other techniques, such as informant interviews [54] and analyses of student journals [30]. The remaining study designs included a practical exam [33], a case study [40], and a randomized experiment [37]. In total, studies assessed approximately 9,850 medical students at 76 medical schools or hospitals (one study [49] did not specify participants' school affiliation). All studies reviewed are listed in Table 1.

Bottom Line: We found that 40%-100% of medical students reported interacting with the pharmaceutical industry.Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism about negative implications of these interactions.Please see later in the article for the Editors' Summary.

View Article: PubMed Central - PubMed

Affiliation: Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.

ABSTRACT

Background: The relationship between health professionals and the pharmaceutical industry has become a source of controversy. Physicians' attitudes towards the industry can form early in their careers, but little is known about this key stage of development.

Methods and findings: We performed a systematic review reported according to PRISMA guidelines to determine the frequency and nature of medical students' exposure to the drug industry, as well as students' attitudes concerning pharmaceutical policy issues. We searched MEDLINE, EMBASE, Web of Science, and ERIC from the earliest available dates through May 2010, as well as bibliographies of selected studies. We sought original studies that reported quantitative or qualitative data about medical students' exposure to pharmaceutical marketing, their attitudes about marketing practices, relationships with industry, and related pharmaceutical policy issues. Studies were separated, where possible, into those that addressed preclinical versus clinical training, and were quality rated using a standard methodology. Thirty-two studies met inclusion criteria. We found that 40%-100% of medical students reported interacting with the pharmaceutical industry. A substantial proportion of students (13%-69%) were reported as believing that gifts from industry influence prescribing. Eight studies reported a correlation between frequency of contact and favorable attitudes toward industry interactions. Students were more approving of gifts to physicians or medical students than to government officials. Certain attitudes appeared to change during medical school, though a time trend was not performed; for example, clinical students (53%-71%) were more likely than preclinical students (29%-62%) to report that promotional information helps educate about new drugs.

Conclusions: Undergraduate medical education provides substantial contact with pharmaceutical marketing, and the extent of such contact is associated with positive attitudes about marketing and skepticism about negative implications of these interactions. These results support future research into the association between exposure and attitudes, as well as any modifiable factors that contribute to attitudinal changes during medical education. Please see later in the article for the Editors' Summary.

Show MeSH
Related in: MedlinePlus