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住院医师培训课程中医生与制药行业互动情况:CERA研究

Residency Curricula on Physician-Pharmaceutical Industry Interaction: A CERA Study.

作者信息

Evans David V, Waters Richard C, Olsen Cara, Stephens Mark B, Brown Steven R

机构信息

Department of Family Medicine, University of Washington.

出版信息

Fam Med. 2016 Jan;48(1):44-8.

Abstract

BACKGROUND AND OBJECTIVES

Physician interaction with pharmaceutical representatives results in less evidence-based prescribing and increased costs. Many organizations have called for strong conflict of interest policies in academic institutions. Implementing policy without educational interventions may not adequately address the influence of industry on physician prescribing patterns. The objective of this study is to assess the implementation and content of family medicine residency curricula on the physician-pharmaceutical industry relationship.

METHODS

We surveyed US family medicine program directors using the Council of Academic Family Medicine Educational Research Alliance (CERA) platform. The presence of a formal curriculum on the physician-industry interaction and specific curricular elements (ethics of interaction, understanding detailing sessions and advertisements, use of unbiased pharmaceutical information) were the outcome measures of interest.

RESULTS

Fifty-two percent (212 of 406) of program directors responded. Forty percent (95% confidence interval [CI]: 33%--46%) reported having a formal curriculum on physician-pharmaceutical industry interactions. The presence of a formal curriculum was more likely in residencies permitting interaction with industry (52% [48/92] versus 30% [36/120]) or with a university affiliation (43% [75/173] versus 19% [7/36]). The use of unbiased sources of information relating to pharmaceutical products and the ethics of the physician-pharmaceutical industry relationship were the most common curricular elements (59% and 55%, respectively).

CONCLUSIONS

This study shows that less than half of US family medicine programs have a curriculum addressing physician-industry interactions. Further research on the efficacy of and barriers to curriculum creation and implementation is warranted.

摘要

背景与目的

医生与医药代表的互动会导致循证处方减少和成本增加。许多组织呼吁学术机构制定强有力的利益冲突政策。在没有教育干预的情况下实施政策可能无法充分解决行业对医生处方模式的影响。本研究的目的是评估家庭医学住院医师培训课程中关于医生与制药行业关系的实施情况和内容。

方法

我们通过学术家庭医学教育研究联盟(CERA)平台对美国家庭医学项目主任进行了调查。关于医生与行业互动的正式课程的存在以及特定的课程内容(互动伦理、理解推广活动和广告、使用无偏见的药品信息)是感兴趣的结果指标。

结果

52%(406人中的212人)的项目主任做出了回应。40%(95%置信区间[CI]:33% - 46%)报告有关于医生与制药行业互动的正式课程。在允许与行业互动的住院医师培训项目中(52%[48/92]对30%[36/120])或有大学附属关系的项目中(43%[75/173]对19%[7/36]),更有可能存在正式课程。使用与药品相关的无偏见信息来源以及医生与制药行业关系的伦理是最常见的课程内容(分别为59%和55%)。

结论

本研究表明,不到一半的美国家庭医学项目设有关于医生与行业互动的课程。有必要对课程创建和实施的效果及障碍进行进一步研究。

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