Reeder M, Dougherty J, White L J
Department of Emergency Medicine, Akron General Medical Center, Ohio.
Ann Emerg Med. 1993 Oct;22(10):1593-6. doi: 10.1016/s0196-0644(05)81266-1.
To determine the extent and diversity of involvement of pharmaceutical representatives in emergency medicine residency programs and to assess chief residents' beliefs and attitudes concerning this activity.
A multi-item survey with cover letter was mailed to the chief resident at each of the 87 Accreditation Council on Graduate Medical Education-approved emergency medicine residency programs in the United States at the time of study conception.
Eighty-three percent (72 of 87) of the questionnaires were returned. Ninety-three percent (66 of 71) of responders reported the involvement of pharmaceutical representatives in their emergency medicine residency. The most frequent activities (90%, 63 of 70) were to distribute small gifts (pens, notepads) and to provide meals during department functions such as journal clubs (80%, 56 of 70). Only 32 of 70 responding chief residents (46%) were aware of any established guidelines in their institution or residency program concerning relationships with pharmaceutical representatives, and 14 respondents (20%) believed that accepting gifts from pharmaceutical companies could affect their own prescribing habits. A few stated that pharmaceutical representative-sponsored educational functions were inappropriate.
The interaction of pharmaceutical representatives with emergency medicine residents and residencies is widespread. More than 50% of the institutions supporting emergency medicine residency programs have no formal guidelines with regard to the interaction of their residents with pharmaceutical representatives or their guidelines are not known to the person most responsible for approval and arrangement of the pharmaceutical representative interaction--the emergency medicine chief resident. While most chief residents believed that accepting small gifts was reasonable, they also believed that accepting gifts valued at $100 or more and pharmaceutical representative sponsorship of trips was inappropriate.
确定医药代表参与急诊医学住院医师培训项目的程度和多样性，并评估住院总医师对此类活动的看法和态度。
在研究构思之时，向美国医学研究生教育认证委员会批准的87个急诊医学住院医师培训项目中的每个项目的住院总医师邮寄了一份附有说明信的多项目调查问卷。
83%（87份问卷中的72份）被返还。93%（71名受访者中的66名）报告称医药代表参与了他们的急诊医学住院医师培训。最常见的活动（90%，70名受访者中的63名）是分发小礼品（笔、便签本）以及在科室活动（如学术研讨会）期间提供餐饮（80%，70名受访者中的56名）。70名做出回应的住院总医师中只有32名（46%）知晓其所在机构或住院医师培训项目中有关与医药代表关系的既定准则，14名受访者（20%）认为接受医药公司的礼品可能会影响他们自己的处方习惯。少数人表示医药代表赞助的教育活动不合适。
医药代表与急诊医学住院医师及住院医师培训项目之间的互动很普遍。超过50%支持急诊医学住院医师培训项目的机构没有关于其住院医师与医药代表互动的正式准则，或者负责批准和安排医药代表互动的人（急诊医学住院总医师）不知道这些准则。虽然大多数住院总医师认为接受小礼品是合理的，但他们也认为接受价值100美元或以上的礼品以及医药代表赞助的旅行是不合适的。
