Inadequate conflict of interest policies at most French teaching hospitals: A survey and website analysis

Guy-Coichard, Christian; Perraud, Gabriel; Chailleu, Anne; Gaillac, Véronique; Scheffer, Paul; Mintzes, Barbara

doi:10.1371/journal.pone.0224193

Cited by 12 publications

(16 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors states that French universities are behind a lot of countries, including the USA. (23,24) Indeed, the American Medical Student Association (AMSA) has been publishing a yearly ranking of American universities since 2007, with much better results.…”

Section: Resultsmentioning

confidence: 99%

GPs and Pharma Reps: Why Are We So Ambivalent? Crossing perspectives from sociology, psychology and general practice toward a qualitative study in France

Barbaroux¹,

Pourrat²,

Feroni³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Receiving a gift from pharma reps or meeting them is correlated with an amount of bigger, more expensive and sometimes less rational prescriptions. French General Practitioners (GPs) tend to express an unfavorable opinion towards the pharmaceutical industry; they however adopt rather favorable behavior with pharmaceutical representatives. Yet no study has sought to understand the reasons for this discrepancy. The aim of this study was exploratory: why do some general practitioners receive pharmaceutical representatives when they express an unfavorable opinion regarding the pharmaceutical industry?Method: Qualitative descriptive study by semi-structured face to face interviews with French GPs of the south-east of France. A general inductive analysis was carried out. Data were analysed by researchers from different disciplines (psychology, sociology and general practice).Results: Ten GPs were interviewed for an average time of 50 minutes. The analysis yield to three forces competing to keep meeting pharmaceutical representatives despite unfavorable opinions towards it: practical reasons such as a substitute for continuous training; social and cultural reasons such as propriety toward representatives; psychological mechanisms such as cognitive dissonance and hidden curriculum. Cognitive dissonance is a well-supported social-psychology theory explaining how it is possible to maintain a behavior despite an unfavorable opinion. Since meeting pharma reps is implemented during traineeship, it could be considered as a part of the hidden curriculum. The strengths of this work are the confrontation of medicine, social psychology and sociology with the original approach of the interpretative phenomenological approach.Discussion: The GPs/representative relationship is complex, involving psychological mechanisms which are unknown to the medical profession. GPs use reps as a convenient continuous education tool furthermore in a private practice setting in which GPs feel they lack time. Lifting the veil of individual ambivalence raises questions which are more social and political than individual.

show abstract

Section: Resultsmentioning

confidence: 99%

GPs and Pharma Reps: Why Are We So Ambivalent? Crossing perspectives from sociology, psychology and general practice toward a qualitative study in France

Barbaroux¹,

Pourrat²,

Feroni³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…A Canadian study reported 81% of students being willing to meet with representatives and 75% willing to accept small gifts such as lunches [32]. In Europe, studies have shown that few teaching hospitals in France and almost no medical schools in Germany have comprehensive conflict of interest policies in place [33,34]. In Germany, no medical school reported teaching on conflicts of interest as part of its medical curriculum [34].…”

Section: Box 1 a Case Study Of Industry Interaction With Academic Res...mentioning

confidence: 99%

Industry influence in healthcare harms patients: myth or maxim?

Trayer

Rowbotham

Boyle

et al. 2022

Breathe

View full text Add to dashboard Cite

Healthcare is a major global industry accounting for a significant proportion of government spending. Drug and medical device manufacturers are publicly traded companies with a responsibility to their shareholders to maximise profits by increasing sales. In order to achieve this, industry exerts influence over every part of healthcare including academic research, medical education, clinical guideline development, physician prescribing and through direct interactions with patients. In contrast, healthcare services seek to provide effective, safe and evidence-based treatments. This article examines interactions with industry across these domains and seeks to identify mutually beneficial relationships and potential conflict leading to patient harms. Case studies are used to illustrate these interactions.There is no single solution for improving healthcare's relationship with industry, although increased transparency has raised awareness of this issue. We briefly discuss some successful interventions that have been tried at national and regulatory level. While industry influence is widespread in healthcare and this has benefits for shareholders, healthcare practitioners have an ethical obligation to prioritise their patients’ best interests. Industry interactions with healthcare professionals have a valid role in product development and distribution, but industry sponsorship of healthcare education and practice, guideline development or regulatory decision-making can have harmful consequences for patients. Healthcare practitioners need to carefully consider these issues when deciding whether to collaborate with industry.Educational aimsTo explore the many areas where industry influences healthcare and the subsequent effects on patient care. Case studies are used to illustrate examples of beneficial and harmful effects of this influence.To raise awareness of the effects of industry influence and for readers to consider their own potential conflicts of interest.To suggest potential ways to improve the current system with a focus on solutions which have successfully been trialled already.

show abstract

“…Research to assess how these establishments manage COI with industry would therefore complement the results of our present study. A study in France was carried out to assess COI policies within university teaching hospitals; only 13 out of the 32 major French teaching hospitals had policies covering at least one of the studied criteria [57]. In the United States, AMSA also conducted a survey of COI in university hospitals.…”

Section: Plos Onementioning

confidence: 99%

Conflict of interest policies at Belgian medical faculties: Cross-sectional study indicates little oversight

et al. 2021

View full text Add to dashboard Cite

Background Medical students encounter pharmaceutical promotion from the very start of their training. Medical schools have an important role to play in educating medical students regarding the interactions between healthcare professionals (HCPs) and industry and in protecting them from commercial influence and conflict of interest (COI). In 2019, medical student associations in Belgium and abroad called for more preparation in dealing with COI and for a more independent medical training. As little information is available on the situation in our country, we undertook an assessment of conflict of interest policies at Belgium’s medical schools. We relied on a methodology already used in studies from USA, Canada, Australia, France and Germany and adapted it to the Belgian context. Methods We identified 10 medical schools in Belgium. We searched the website of each medical school in November 2019 with standardized keywords for COI policies and learning activities on COI in the curriculum. The deans of medicine were invited to participate by sending us information that we could have overlooked during our web-based searches. We also consulted personal contacts within faculties among students and teachers. Based on a list of 15 criteria adapted from North American and French studies, we calculated a total for each faculty of medicine with a maximum score of 30 points. Results By December 2019, we had gathered a set of written documents for four faculties of medicine (40%) containing policies with varying degrees of precision and relevance to our survey. We found elements of the curriculum addressing the COI issue for one faculty (10%). In all cases, these policies consisted of “moderate” initiatives with little or no “restrictive” elements. Only one faculty showed interest in our study by providing us with relevant information (10%). Half of the faculty notified us of their refusal to participate in the study (50%) and the other faculties either did not respond or did not provide us with any information (40%). The maximum score obtained was 3 out of 30 points with six faculties scoring 0 (60%). Conclusion There is little transparency regarding interactions between medical students and pharmaceutical companies at Belgian medical faculties, which may create COI issues. Initiatives to protect students from pharmaceutical promotion and to train them to manage their future interaction with pharmaceutical companies have a limited scope and are isolated. This is inconsistent with international recommendations from Health Action International, World Health Organization or the American Medical Students’ Association. The Belgian government has legislated in favor of more transparency in the relation between HCPs and pharmaceutical industry. Indeed, it made the disclosure of benefits granted by the industry compulsory and limited their value. Our results show that there is still some way to go to ensure an independent medical training for future Belgian physicians.

show abstract

Inadequate conflict of interest policies at most French teaching hospitals: A survey and website analysis

Cited by 12 publications

References 32 publications

GPs and Pharma Reps: Why Are We So Ambivalent? Crossing perspectives from sociology, psychology and general practice toward a qualitative study in France

GPs and Pharma Reps: Why Are We So Ambivalent? Crossing perspectives from sociology, psychology and general practice toward a qualitative study in France

Industry influence in healthcare harms patients: myth or maxim?

Conflict of interest policies at Belgian medical faculties: Cross-sectional study indicates little oversight

Contact Info

Product

Resources

About