Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS Med. 2011 May;8(5):e1001037. doi: 10.1371/journal.pmed.1001037. Epub 2011 May 24.
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.
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.
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.
健康专业人员与制药行业之间的关系已成为争议的根源。医生对行业的态度可能在职业生涯早期就形成，但人们对这一关键发展阶段知之甚少。
我们根据 PRISMA 指南进行了系统评价，以确定医学生接触制药行业的频率和性质，以及学生对制药政策问题的态度。我们检索了 MEDLINE、EMBASE、Web of Science 和 ERIC，最早可追溯到 2010 年 5 月，还检索了选定研究的参考文献。我们寻找了报告医学生接触药品营销、对营销实践、与行业关系以及相关制药政策问题的态度的原始研究。在可能的情况下，将研究分为临床前培训和临床培训，并使用标准方法进行质量评估。有 32 项研究符合纳入标准。我们发现，40%-100%的医学生报告与制药行业有过互动。相当一部分学生（13%-69%）认为行业赠品会影响处方。有 8 项研究报告了接触频率与对行业互动的有利态度之间的相关性。学生对医生或医学生的赠品比对政府官员的赠品更认可。某些态度似乎在医学院期间发生了变化，但没有进行时间趋势分析；例如，临床学生（53%-71%）比临床前学生（29%-62%）更有可能报告促销信息有助于了解新药。
本科医学教育提供了与药品营销的大量接触，这种接触的程度与对营销的积极态度以及对这些互动的负面影响的怀疑态度有关。这些结果支持未来对接触和态度之间的关联以及医学教育期间促成态度变化的任何可改变因素的研究。请在文章后面查看编辑摘要。
