Interaction of nurses, pharmacists, and other non-physician clinicians within pharmaceutical industry is common

November 26, 2013, Public Library of Science

Scrutiny of physician relationships with industry has culminated in passage of the US Physician Payments Sunshine Act (part of the Affordable Care Act), intended to bring greater transparency to such relationships. However, according to authors in this week's PLOS Medicine, interactions with industry of non-physician clinicians—Registered Nurses, advanced practice nurses with prescriptive authority, physicians' assistants, pharmacists, dieticians, and physical or occupational therapists—have not undergone the same scrutiny, although they may be involved in the same types of decision making as physicians. Quinn Grundy (Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco) and colleagues conducted the first (to their knowledge) systematic review of the evidence regarding interactions of non-physician clinicians with industry and beliefs regarding such interactions.

In a search of studies published in Medline and Web of Science through June 2013, the researchers identified 15 studies that met their inclusion criteria. Overall, non-physician clinicians reported meeting regularly with from the ; few had eliminated these meetings from their practice. The majority of sampled nurses, nurse practitioners, and Registered Nurses reported receiving gifts, food and beverages including sponsored lunch and dinner events. Non-physician clinicians reported frequent receipt of samples of pharmaceuticals and other medical products for patient use and they generally held favorable views of such samples. Large majorities of non-physician clinicians reported attending -sponsored educational events or receipt of industry-provided educational materials. Most non-physician clinicians across disciplines held favorable views of interactions with sales representatives and in general. A minority perceived that industry marketing influenced their own practice, but more felt their colleagues would be influenced. Preparation for industry interactions generally was not a part of professional training. In addition to the pharmaceutical industry, the infant formula industry targeted marketing efforts at non-physician clinicians.

The authors state, "The frequency of industry interactions and, despite clinician recognition of the potential for bias and conflict of interest, the common view of industry as at worst, a 'necessary evil', suggest that clinician-industry interactions are normalized in clinical practice settings." The authors acknowledge several limitations of their study, including that the studies were observational and of varying methodological rigor, thus the findings may not be generalizable, and given the types of studies the prevalence or frequency non-physician clinician-industry interactions could not be quantified.

In a related Perspective, James Yeh and Aaron Kesselheim (Harvard University, Boston, MA) state that while recent policy changes may have been successful in insulating more physicians from promotional interactions, "By contrast, the study from Grundy and colleagues shows that promotion to non-physician health care providers remains vibrant." They suggest that because current programs intended to provide transparency about the prevalence of pharmaceutical industry marketing may not reach the non-physician clinician population, institutional policies should be constructed to apply to all providers of patient care.

Explore further: Medical students have substantial exposure to pharmaceutical industry marketing

More information: Grundy Q, Bero L, Malone R (2013) Interactions between Non-Physician Clinicians and Industry: A Systematic Review. PLoS Med 10(11): e1001561. DOI: 10.1371/journal.pmed.1001561

Related Stories

Medical students have substantial exposure to pharmaceutical industry marketing

May 24, 2011
Medical students in the United States are frequently exposed to pharmaceutical marketing, even in their preclinical years, and the extent of their contact with industry is associated with positive attitudes about marketing ...

Physician shortage could be cut by new primary care models, study finds

November 4, 2013
Much of the shortage of primary care physicians expected over the next decade could be eliminated if the nation increases use of new models of medical care that expand the role of nurse practitioners and physician assistants, ...

Survey shows medical students have frequent interactions with pharmaceutical companies

February 26, 2013
A first-of-its kind national survey of medical students and residents finds that despite recent efforts by medical schools and academic medical centers to restrict access of pharmaceutical sales representatives to medical ...

Family doc finds mid-level providers increase revenue

November 26, 2013
(HealthDay)—Hiring mid-levels—physicians assistants and nurse practitioners—can improve productivity, resulting in increased physician take-home pay, according to an article published Nov. 10 in Medical Economics.

Family medicine continues to provide care for pregnant women

July 18, 2013
(HealthDay)—The proportion of pregnant women receiving care from family medicine providers has remained steady nationally from 2000 to 2009, although regional differences are apparent, according to a study published in ...

Recommended for you

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.