Promotion or education: a content analysis of industry-authored oral health educational materials targeted at acute care nurses.

OBJECTIVES

To assess the nature, quality and independence of scientific evidence provided in support of claims in industry-authored educational materials in oral health.

DESIGN

A content analysis of educational materials authored by the four major multinational oral health product manufacturers.

SETTING

Acute care settings.

PARTICIPANTS

68 documents focused on oral health or oral care, targeted at acute care clinicians and identified as 'educational' on companies' international websites.

MAIN OUTCOME MEASURES

Data were extracted in duplicate for three areas of focus: (a) products referenced in the documents, (b) product-related claims and (c) citations substantiating claims. We assessed claim-citation pairs to determine if information in the citation supported the claim. We analysed the inter-relationships among cited authors and companies using social network analysis.

RESULTS

Documents ranged from training videos to posters to brochures to continuing education courses. The majority of educational materials explicitly mentioned a product (59/68, 87%), a branded product (35/68, 51%), and made a product-related claim (55/68, 81%). Among claims accompanied by a citation, citations did not support the majority (91/147, 62%) of claims, largely because citations were unrelated. References used to support claims most often represented lower levels of evidence: only 9% were systematic reviews (7/76) and 13% were randomised controlled trials (10/76). We found a network of 20 authors to account for 37% (n=77/206) of all references in claim-citation pairs; 60% (12/20) of the top 20 cited authors received financial support from one of the four sampled manufacturers.

CONCLUSIONS

Resources to support clinicians' ongoing education are scarce. However, caution should be exercised when relying on industry-authored materials to support continuing education for oral health. Evidence of sponsorship bias and reliance on key opinion leaders suggests that industry-authored educational materials have promotional intent and should be regulated as such.