E-DRUG: Drug promotion & ir(rational) prescribing (contd)
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Dear E-druggers,
Further to the discussion on drug promotion, and in particular
the activities of pharmaceutical representatives, I have attached
the abstract from my thesis on this topic. The audio-recordings
reported here were collected in Australia between Dec 92 and Feb
94 and were recorded with the informed consent of the medical
practitioner and pharmaceutical representative. In addition to the
analysis of the information content reported in the abstract below,
we also analysed the influence technique used. Sorry, but this work
has not been published apart from in my thesis.
Kind regards
Libby Roughead
School of Pharmacy
University of South Australia
North Terrace
Adelaide 5000
South Australia
Australia
Email: 951026p@ntx.city.unisa.edu.au
Abstract:
The pharmaceutical representative and medical practitioner
encounter: Implications for quality use of medicines.
Objective: To determine the type of drug information provided
by pharmaceutical representatives within their verbal
presentations to medical practitioners.
Design: Qualitative and quantitative analysis of
audio-recordings of pharmaceutical representatives'
presentations to general practitioners.
Setting: Suburban practices of general practitioners
Main outcome measures: Transcripts were assessed for accuracy,
omissions and balance by comparison with Australian Approved
Product Information (AAPI) and by comparison with prescribing
guidelines where applicable.
Results: Sixteen recordings, detailing 64 medicines, were
obtained from seven medical practitioners. Thirty-eight of
the 64 products were prescription-only-medicines. Indications
were mentioned in 73% of the details, contraindications were not
mentioned and use in pregnancy was mentioned on one occasion.
Adverse reactions were mentioned in 27% of the details,
precautions in 15% and a relevant warning on only one occasion.
Information concerning dosage and administration was mentioned
in 48% of the details. The qualitative analysis found risk
information to be associated with claims that risk was minimal
or lower than with alternative products. Presentations were not
judged to be balanced and 13 were found to contain inaccuracies
against AAPI, with 23 inaccurate statements recorded in total.
Inaccuracies included the promotion of non-approved indications.
Comparative product information and data from scientific
studies was provided, but this information was incomplete,
sometimes inaccurate and it appeared to be used to promote product
benefits, while down playing risks. The medical practitioners'
role in the encounter was limited. They did not often ask for
information which was not spontaneously mentioned by the
pharmaceutical representatives.
Conclusion: The results of this research raise important questions
concerning the role of pharmaceutical representatives, their
standards of practice, the regulation and monitoring of their
practice and the implications these practices have for the quality
use of medicines.
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