Abstract
BackgroundThe present study aimed to describe exposure and attitudes of French medical residents towards pharmaceutical industry. The study was performed shortly after the Mediator affair which revealed several serious conflicts of interest inside the French health system.Methods and FindingsA cross-sectional study was implemented among residents from 6 French medical faculties. Independent education in pharmacology, attitudes towards the practices of pharmaceutical sales representatives, opinions concerning the pharmaceutical industry, quality of information provided by the pharmaceutical industry, and opinions about pharmaceutical company sponsorship were investigated through a web-based questionnaire. We also assessed potential changes in resident attitudes following the Mediator affair. The mean value of exposure to drug companies was 1.9 times per month. Global opinions towards drug company information were negative for 42.7% of the residents and positive for only 8.2%. Surprisingly, 81.6% of residents claimed that they had not changed their practices regarding drug information since the Mediator affair. Multivariate analyses found that residents in anesthesiology were less likely to be exposed than others (OR = 0.17 CI95% [0.05–0.61]), exposure was significantly higher at the beginning of residence (p<0.001) and residents who had a more positive opinion were more frequently exposed to drug companies (OR = 2.12 CI95% [1.07–4.22]).ConclusionsResident exposure to drug companies is around 1 contact every 2 weeks. Global opinion towards drug information provided by pharmaceutical companies was negative for around 1 out of 2 residents. In contrast, residents tend to consider the influences of the Mediator affair on their practice as relatively low. This survey enabled us to identify profiles of residents who are obviously less exposed to pharmaceutical industry. Current regulatory provisions are not sufficient, indicating that further efforts are necessary to develop a culture of disclosure of conflict of interest and of transparency in residents.
Highlights
Residence, a 3 to 5-year period for clinical practice in hospitals at the end of medical studies, is a critical time for young physicians to learn the principles that will guide them throughout their whole career, in particular prescribing habits
Global opinion towards drug information provided by pharmaceutical companies was negative for around 1 out of 2 residents
This survey enabled us to identify profiles of residents who are obviously less exposed to pharmaceutical industry
Summary
A 3 to 5-year period for clinical practice in hospitals at the end of medical studies, is a critical time for young physicians to learn the principles that will guide them throughout their whole career, in particular prescribing habits. During this period, residents begin to interact with the pharmaceutical industry through information provided by pharmaceutical sales representatives (PSRs), at product meetings and/or in the medical literature they provide. Exposure to pharmaceutical representatives was found to be associated with irrational prescribing [8,9] and additional cost [10] Relationships between drug companies and physicians often lead to gifts, sponsoring for diners or medical meetings [11]. The study was performed shortly after the Mediator affair which revealed several serious conflicts of interest inside the French health system
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