Promotional Literature Research Articles

A Cross-Sectional Evidence-Based Review of Drug Promotional Literature (DPL) in a Government Medical College

A Cross-Sectional Evidence-Based Review of Drug Promotional Literature (DPL) in a Government Medical College

Evaluation of the Effect of Drug Promotional Literature on Prescribing Pattern using WHO Prescribing Indicators and Other Relevant Parameters

ABSTRACT Background: Medicines are an integral part of health. It becomes essential to promote rational drug use. The relationship between doctors and the pharmaceutical industry has gained increasing attention recently. So there are chances that detailing activities by pharmaceutical representatives may lead to an undesirable effect on the prescribing pattern of doctors, like polypharmacy and use of fixed drug combinations; hence this study was planned to evaluate the effect of evaluation of the effect of drug promotional literature on prescribing using WHO prescribing indicators (DPL) on the prescribing pattern of doctors. Setting and Design: This prospective observational cross-sectional study was performed in a medical college and tertiary care center in Maharashtra. Materials and Methods: 30 DPL and 10 prescriptions from each doctor were collected. Such total of 3000 DPL and 1000 prescriptions were collected from 100 doctors. Statistical Analysis: The prescriptions and DPL were analyzed together, and information was entered in Microsoft Excel; the parameters were calculated in percentage. Results: This study highlighted that drugs prescribed by generic name were 3.36%, the percentage of antibiotics prescribed was 27.37%, and the percentage of prescriptions containing medicines from the essential medicine list (EML) or formulary was 44.07%. In this study, 27.9% of drugs in the prescriptions were those drugs that are advertised in the DPL. Conclusion: Polypharmacy, prescribing drugs by brand names, drugs out of national list of essential medicine, use of more fixed drug combinations (FDC), antibiotics, and nutritional supplements could be attributed to the effect of DPL on the prescribing pattern. Hence it could be said that there is an association between a greater reliance on the promotion of medicines by the pharmaceutical companies and inappropriate prescribing patterns.

Evaluation of promotional drug literature using WHO guidelines: comparison between present and previous data

Evaluation of promotional drug literature using WHO guidelines: comparison between present and previous data

CRITICAL ANALYSIS OF CLAIMS IN DRUG PROMOTIONAL LITERATURE AVAILABLE TO MEDICAL PRACTITIONERS

Context: Objective: To ascertain whether the pharmaceutical companies are following the World Health Organisation (WHO) criteria for Ethical Medicinal Drug Promotion 2015 and Organisation of Pharmaceutical Producers of India (OPPI) Code of Pharmaceutical Marketing Practices, 2019 and to what extent. Also, to evaluate the therapeutic claims made by them in their drug promotional literature (DPL) and to classify them. Methods: DPL brochures were collected from different pharmaceutical companies from various medical practitioners and assessed for ethical promotion based on guidelines. Therapeutic claims made by them were classified as authentic, exaggerated, controversial, false, misinterpreted, and ambiguous. Results: A total of 100 DPLs were collected and critically analyzed for authenticity of the content. It was observed that the majority of the DPLs did not comply with the criteria mentioned in the WHO Criteria of Ethical Promotion 2015 and the OPPI Code of Pharmaceutical Practices 2019. International non-proprietary names and the brand name were mentioned by 100% of DPLs. The amount of active ingredients and approved therapeutic indications were mentioned by (99%) and (96%) respectively. The dosage form or regimen was mentioned by 87% of DPLs. Criteria like side effects, precautions/contraindications, and major interactions were mentioned in 28%, 29%, and 14% respectively. Based on the therapeutic claims 23% of the DPLs were found to be authentic and the remaining 77% were extravagant. Conclusions: This study enabled us to find out to what extent the pharmaceutical industries follow the standard criteria for DPL and evaluate the claims made by them. The majority of the DPLs did not follow ethical guidelines and were inadequate in terms of their adequacy, quality, and reliability.

Cultural blind spots: Identifying hidden psychosocial hazards in the workplace.

This article presents a framework to identify hidden psychosocial hazards and emerging mental health risks in the workplace, thereby assisting Persons Conducting a Business or Undertaking. The framework adds value to the processes outlined in SafeWork NSW's Code of Practice for Managing Psychosocial Hazards At Work. Specifically, the article documents a framework to analyse microcultures and back stage sites of enactment where psychosocial hazards and risks may be hidden or obscured in workplace settings. The article's framework aims to bring to the surface both the intra and interpersonal tensions employees experience in the social reality they inhabit while they perform their work, thereby positively contributing to organisations and PCBUs by helping them create healthy workplace cultures and psychological safety. Specifically, the article discusses partnering with an organisational ethnographer when a PCBU embarks upon psychosocial investigations to: gain access, select employee participants, start conversations, establish rapport, build trust, collect and analyse data. This article theoretically contributes to health promotion literatures by offering organisations a complementary way of extracting deeper insights and understandings of psychosocial hazards and emerging mental health risks which are not apparent with traditional methods of inquiry.

Navigating travel decisions in health crises: The interplay of message framing, regulatory focus, and perceived risk

This study investigates the impact of promotional message framing on domestic tourists' travel intentions during a health crisis, exploring the moderating effects of regulatory focus and perceived risk. Utilizing a 2 × 2 × 2 between-subject factorial design, two experiments were conducted with data collected from domestic tourists. The findings reveal that promotion-focused tourists prefer emotionally resonant gain-framed messages with lower discounts and show lower susceptibility to health risks compared to their prevention-focused counterparts. The interaction of gain-framed messages with low discount depth resulted in increased travel intentions despite the health crisis. On the other hand, prevention-focused tourists exhibited no significant change in travel intentions in response to differently framed messages. This study extends the promotional framing literature by incorporating regulatory focus and risk perception, offering practical implications for the tourism industry, particularly during a time of health crisis.

How researchers can translate health evidence into books for children.

The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication materials. This has resulted in a knowledge gap regarding effective knowledge translation processes. This study explores the process, reasoning and practices for developing books for children that incorporate evidence-based information to aid understanding of scientific evidence about health and environmental or natural disasters. This study is informed by a systematic review of the literature combined with responses to an email interview with authors of books for children. Nine published studies were included in the systematic review. Twenty-two authors responded to the email survey (25% response rate, following 86 invitations). We report seven key findings to guide the development of health-promoting books for children: (i) understand the needs and expectations of the audience, (ii) articulate the topic and research evidence, (iii) assemble a team with a mix of content knowledge and creative expertise, (iv) format should be chosen to suit the user group and guided by the creative team, (v) early testing with children and their support system is crucial, (vi) develop a dissemination strategy to reach the user group and (vii) engage in reflexivity through evaluation of effectiveness of messaging. The current investigation can guide the process, reasoning and practice of developing books for children that incorporate evidence about health and environmental disasters.

An evaluation of drug promotional literature in clinical practice

Background: In current clinical practice, pharmaceutical companies use drug promotional literatures (DPLs) as a promotional tool to introduce new products entering into the market to medical practitioners. DPLs play a major role in providing important information about the drug to the health-care professionals and to convince them to prescribe the same. Aims and Objectives: The aims and objectives of the study are to evaluate the appropriateness of DPLs as per the World Health Organization (WHO) criteria for rational drug promotion and for other information such as the pictures given and the presence of self-boasting words, if any. Materials and Methods: A cross-sectional observational study was conducted from December 2022 to May 2023 at a tertiary care teaching institute in southern Rajasthan, India. 330 DPLs, using convenient sampling, were collected in the form of hard and soft copies of flyers, leaflets, brochures, and pamphlets from various registered medical practitioners from a variety of departments and were evaluated based on the WHO guidelines. Results: A total of 330 DPLs were evaluated. Generic name was present in 98.2%, brand name in 97.9%, amount of active ingredient in 90%, name of manufacturer in 100%, and reference to scientific literature in 57.6%. About 75.5% of DPLs depicted photographs and 53% mentioned self-boasting words or phrases. Conclusion: Only few DPLs fulfilled all eleven criteria laid down by the WHO. Hence, doctors should not rely solely on promotional literature and appropriate policies must be made for vigilance of the DPLs.

Wellbeing-responsive community: a growth target for intentional mental health promotion.

With mental illness remaining a significant burden of disease, there is an ongoing need for community-based health promotion, prevention, and responses (or "mental health promotion activities"). The health promotion, community development, and positive psychology literature identifies significant heterogeneity in the design and delivery of these activities. This variability spans: (1) individual vs. group outcomes, (2) psychological vs. sociological determinants of change, (3) promoting wellbeing vs. reducing mental health symptoms, and (4) the degree activities are contextualized vs. standardized in design and delivery. Mental health promotion activities do not easily accomplish this level of complexity within design and implementation. This has led to the emergence of the complexity-informed health promotion literature and the need for innovative tools, methods, and theories to drive this endeavor. This article directly responds to this call. It introduces "wellbeing-responsive community": a vision and outcome hierarchy (or growth target) for intentionally delivered mental health promotion. The construct enables the design and implementation of interventions that intentionally respond to complexity and contextualization through the drivers of co-creation, intentionality, and local empowerment. It represents a community (support team, programme, agency, network, school, or region) that has the shared language, knowledge, methods, and skills to work together in shared intent. In other words, to integrate best-practice science with their local knowledge systems and existing strengths, and intentionally co-create and deliver contextualized wellbeing solutions at both the individual and community levels that span the "system" (e.g., whole-of-community) to the "moment" (e.g., intentional support and care). Co-creation, as applied through a transdisciplinary lens, is emerging as an evidence-based method to respond to complexity. This article describes the rationale and evidence underpinning the conceptualization of a wellbeing-responsive community through the integration of three key disciplines: (1) positive psychology, (2) ecological or systems approaches, and (3) intentional practice (implementation science). A definitional, contextual, and applied overview of the wellbeing-responsive community is provided, including a hierarchy of outcomes and associated definitions. Its purported application across education, mental health, community service, and organizational settings is discussed, including its potential role in making complexity-informed health promotion practical for all knowledge users.

Knowledge attitude and practices of drug promotional literature: a clinician’s perspective

Background: Promotion of drugs by pharmaceutical industries is fully regulated by drug regulators. Doctors are focus of intense marketing by representatives of pharmaceutical companies (MR). It is reported that very few physicians are equipped with the necessary skills and knowledge to critically assess the information delivered in drug promotional literature (DPL). Hence this study was carried out with the objective to determine knowledge, attitude and practices of doctors about the DPL Methods: This was a questionnaire-based study population included clinicians working in a government set up and others doing private practice. Questionnaire was circulated online on social media platforms via Google forms. Results: The 32.11% participants were aware of regulations and guidelines of DPL in India 80.7% participants searched for cost of medicine on DPL, 54.12% respondents perceive that the product claims made on DPL are balanced and supported by good evidence, 56.88% participants opined that their integrity is compromised by accepting gift from MR, 43.1% participants are exposed to drug advertisement through social media and 51.06% of them opined that their prescribing habits are influenced through this. Writing brand names while prescribing is significantly more in private practitioners as compared to doctors employed in government set up. Conclusions: DPL serves to update the knowledge of the busy clinicians of the latest developments in the medical field. Quality check of drug promotion on social media is the need of the hour as this is influential. Private practitioners need to be addressed regarding enforced laws for rational prescribing.

Negotiating healthy food retail initiatives: An ethnographic study of a partnership with supermarkets

Abstract Background The health promotion literature advocates for partnerships with private actors, but scholars have called for detailed knowledge on the development of interventions in studies using such co-approaches. This study aims to increase our understanding of how such partnerships influence intervention development and content. In 2019, researchers at the National Institute of Public Health, Denmark, established a partnership with the food retailer Salling Group and the Danish Cancer Society, which will be the case used in this study. The vision of the partnership was to develop and test healthy food retail initiatives to make the healthy choice the easy choice for customers. Methods We performed a focused ethnographic study from the initiation of the partnership (2019) until the feasibility test of the initiatives (2021). We used participant observation of meetings and intervention development activities, interviews with partners, and document analysis of e-mail correspondences and project materials. We analysed data abductively with inspiration from a chronological narrative analytical approach and concepts of partnerships, negotiation, and institutional logics. Findings We identified six phases of the development process, characterized by randomness, compromises, fear, conflicting logics, and unforeseen events. We show how 1) a random meeting and initial verbal agreements between a few persons affect the mindset and decision-making of the partners, 2) conflicting logics can both hinder and facilitate the development of initiatives, and 3) the process is shaped by unforeseen events i.e., Covid-19 restrictions, and organisational changes. Conclusions This study highlights how fragile public-private partnerships are and the significance of each step taken. To succeed with effective health promotion in the retail setting partnerships may benefit from being flexible and investing time in forming a shared understanding based on discussions of different perspectives. Key messages • Partnerships between academics and non-academics are fragile and unpredictable. • Negotiation of healthy food retail initiatives is facilitated and hindered by differences in institutional logics.

Metaphor and English Promotional Tourism Discourse: Systematic-narrative Hybrid Literature Review and Future Research Areas

As there is lack of a research synthesis on metaphor in tourism discourse up to date, the paper offers a novel contribution by summarising empirical literature on metaphor use in print and digital tourism promotional materials and identifying the existing research gaps. The review uncovers that figuration is largely underexplored in tourism promotion literature revealing only general functions and specific examples of metaphors. The paper also presents preliminary results from ongoing research on metaphor use in English e-promotional tourism discourse. Thereby, the paper provides new insights into metaphor as a multifaceted phenomenon integrating discursive, conceptual, and cultural elements and contributes to our understanding of the role of metaphor in cross-cultural communication.

‘At the breast is best?’ A corpus-informed feminist critical discourse analysis of the marginalisation of expressing human milk in online infant feeding promotional discourse

Existing feminist analyses of infant feeding practices have examined the promotion of long-term exclusive direct breastfeeding (DBF) as symbolic of “total motherhood” (Wolf 2011), where formula feeding is framed in contrast as “risky” (Murphy 1999, 2000; Brookes et al 2016; Woollard 2018). Discourses of expressing human milk (EHM), and their discriminatory potential, are currently under-researched. However, researchers note that rhetorical strategies that exclude EHM as a form of breastfeeding can reinforce the perceived normalcy of feeding at the breast and relegate breastmilk expression and formula feeding as “deviant” practices (Murphy 1999; Hunt and Thomson 2017; Rasmussen et al., 2017; Coffey-Glover, 2020; Anders et al 2022).To that end, this study integrates Feminist Critical Discourse Analysis (Lazar 2005, 2007, 2014) and corpus linguistics (e.g. Baker 2014) to examine discourses of breastmilk expression (EHM) in a corpus of online infant feeding promotional literature taken from seven organisations, with a particular focus on the largest two organisations in the corpus: La Leche League Great Britain (LLLGB) and the UK National Health Service (NHS). The analysis reveals language choices that marginalise EHM in servitude of “breast is best” (Murphy 1999), and specifically reinforce the message that ‘at the breast is best’. We show how EHM is marginalised in the texts via representations of exclusive DBF as the ‘gold standard’ of infant feeding, recirculating discourses of “total motherhood” (Wolf 2011), “natural mothering” (Bobel 2003) and “intensive motherhood” (Hays 1996).

Perception, knowledge and attitudinal assessment of drug promotional literature among second year, medical undergraduate students: a questionnaire-based study

Background: WHO defines drug promotion literature (DPL) as “all informational and persuasive activities by manufacturers, the effect of which is to induce the prescription, supply, purchase and/or use of medicinal drugs”. Benefit driven marketing of new drugs by drug companies may lead to erroneous prescription due to insufficient understanding, knowledge of safety and therapeutic benefits of the drugs in the community. All these promotional activities influence the prescribing pattern of doctors. 2nd year of undergraduate medical course is the appropriate time to educate the medical undergraduate students about fundamentals of DPL and to train them accordingly for improving their prescribing behaviour eventually. Methods: A prospective questionnaire-based study was conducted in Goa Medical College. The study participants consisted of 150 II-year undergraduate medical students. Approval from Institutional Ethics Committee was obtained. The feedback forms were collected from the students after they were completed and data was analysed and represented as counts and percentages. Results: Among respondents 36% of students opined that the quality of details provided by medical representatives is biased and too commercial followed by others. 40.7% of students were of the view that the most important intervention needed to reduce the impact of drug promotion on prescribing was to formulate policies and guidelines for the health care authorities. Conclusions: Promotional activities by manufacturers influence the attitude and prescribing pattern of doctors. So, it is of utmost importance to train medical graduates in order to enable them to develop the skill of critical analysis of DPL and consequently rational prescribing.

Innovating urban governance through ‘Challenges’

ABSTRACT In recent years, urban “Challenges”—competitions that solicit and reward novel solutions to urban policy problems—have become embedded within a wider program of governance innovations presented to city governments as effective means to solve complex urban problems. This paper offers an overview and critical evaluation of the uses of Challenges in contemporary urban governance innovation, based on an extensive analysis of existing Challenges and related practitioner and promotional literature. Situating Challenges within the increasingly prominent urban governance innovation trends, we suggest a fourfold categorization for understanding the diverse positionings, motivations and objectives at play in the application of Challenges. We present a critique of the prominent logics of projectification, technological solutionism and competition associated with Challenges and conclude by offering coordinates for more intensive and contextually-specific analyses of the Challenge phenomenon.

Characterization of critical health promotion: a scoping review protocol.

This scoping review will explore how critical health promotion is characterized in the health promotion literature. Critical health promotion has emerged as a social justice approach to health promotion to address the persistent global issue of health inequity. Whilst critical health promotion is not conceptually new and the term has been used in the literature, albeit sparingly, this approach has not been adopted as standard health promotion practice, compromising the advancement of health equity. Given that language shapes the understanding and practice of health promotion, it is imperative to explore how critical health promotion is characterized in the literature to increase uptake of the approach. This review will consider sources that explore critical health promotion and are explicitly positioned as health promotion sources. Scopus, CINAHL (EBSCOhost), PubMed, Global Health (CABI), and the Public Health Database (ProQuest) will be searched to identify relevant full-text papers, including original research, reviews, editorials, and opinion papers. Searches of Google Scholar, Google, and ProQuest Dissertations & Theses Global (ProQuest) will be undertaken to identify gray literature. No language or date restrictions will be applied. Two reviewers will screen sources and extract data using a tool that will be pilot tested, modified, and revised, as necessary. Analysis will involve basic frequency counts and descriptive qualitative content analysis through basic coding. The results will be presented in tables, charts, and word clouds, accompanied by a narrative summary.

A Dual-Process Model of Promoting Employee Mental Health in Crises: Impacts of Leadership Health Support and Organizational Leaders’ Crisis Communication in COVID-19

ABSTRACT This study examined how organizations may promote their employees’ mental health in difficult times. Drawing from organizational crisis communication and organizational health promotion research, it proposed and tested a dual-process model that links leadership health support, an essential dimension of organizational health culture, with organizational leaders’ crisis communication (i.e. use of ethical-base responses) and workers’ self-care awareness and perceived stress in a crisis. Through a survey of 502 full-time U.S. employees conducted during COVID-19, we found that organizational leaders’ use of ethical-base responses predicted employees’ enhanced self-care awareness and decreased stress levels. Further, leadership health support provided a double-buffer effect to sustain employee mental health by directly bolstering employees’ self-care awareness and organizational leaders’ use of ethical-base responses. The findings of this study bridge the gaps in organizational health promotion and crisis communication literature and offer practical suggestions for organizations seeking to foster employees’ mental health challenges during crises.

Critical Evaluation of Drug Promotional Literature Using WHO Ethical Criteria and Perception of Clinicians at a Tertiary Care Hospital

Objective To evaluate the rationality of drug promotional literature (DPL) using World Health Organization (WHO) ethical criteria and to evaluate the perception of clinicians regarding DPLs using prevalidated criteria. Methods The promotional material was collected at a tertiary care teaching hospital over a period of 3 months. The perception of different prescribers has been changed. The data were analyzed using descriptive analysis. Results 191 DPLs were collected from various outpatient departments at a tertiary care hospital. The information regarding brand name, generic name, and active ingredients was mentioned in 100% of the collected material. Therapeutic uses of the promotional agents were mentioned in only 60.20%; references were cited in only 15.18%. The adverse effects were listed in only 17.80% of the DPLs. The perception regarding DPLs was gathered from 27 physicians at the same institute. The percentage of clinicians who were aware of the WHO criteria used for analyzing DPL was only 37.03%. All healthcare workers have agreed on the necessity of including critical appraisal of the DPLs in the undergraduate curriculum.

Rachel Winchcombe. Encountering Early America.

At Elizabeth I’s death in 1603, an Atlantic English empire was still very much in doubt after a string of failed ventures in North America. Nevertheless, Rachel Winchcombe argues in Encountering Early America, sixteenth-century attempts at expansion were not mere precursors to permanent colonies, as many scholars suggest, but the foundation upon which they were built. Focusing on assumptions in promotional literature about life’s quotidian aspects (climate, dress, and food) and how they explicated cultural differences and a region’s commercial prospects—what she calls the “embodied nature of early colonization” (18)—Winchcombe amply demonstrates that English attitudes toward the New World were not static. Instead, from initial American encounters through translations of Spanish, French, and Portuguese chronicles and sporadic early voyages to more sustained Elizabethan efforts in the Arctic, Newfoundland, and Virginia, English ideas about the New World shifted and were reshaped, sometimes radically, to assess what had gone wrong and modify the approach in subsequent attempts. Adjustments in the imperial narrative were only partly consolatory; other factors like deteriorating Anglo-Spanish relations, metropolitan anxieties surrounding luxury, idleness, and the progress of reformed religion, and economic volatility in staple industries played a more significant role in its evolution. This process was “messy and unsuccessful, but also adaptive, dynamic, and crucial to later success” (6).

Defrocking the false father of the ‘Driftless Area’, USA

The Driftless Area is a designation popular in American promotional tourist literature for an area in four contiguous American states, Minnesota, Wisconsin, Iowa and Illinois, that were not glaciated during the latest ice advance. Geographer Lawrence Martin published several articles asserting that geologist William H. Keating first discovered this area in 1823, an error that has crept into subsequent accounts. But historical evidence goes to show that three geologists, Roland D. Irving, Newton H. Winchell and Thomas C. Chamberlin, were simultaneous originators of the concept as we understand it today, about the year 1877.