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Educational Initiatives for Medical and Pharmacy Students about Drug Promotion: An International Cross-Sectional Survey - EDM Research Series No. 036
(2005; 61 pages) View the PDF document
Table of Contents
View the documentAcknowledgements
Open this folder and view contentsExecutive summary
View the documentIntroduction
View the documentMethods
Open this folder and view contentsResults
View the documentDiscussion
View the documentConclusions
View the documentReferences
View the documentAppendix 1: Sample questionnaire
View the documentAppendix 2: Country breakdown in total
 

Appendix 2: Country breakdown in total

* Includes Taiwan, Province of the People’s Republic of China.


Country

Frequency

Antigua

1

Argentina

2

Australia

11

Austria

1

Bangladesh

1

Belgium

5

Canada

13

Croatia

2

Cuba

2

Czech Republic

4

Denmark

2

Ecuador

1

Egypt

1

Estonia

1

Fiji

1

Finland

2

France

10

Germany

5

Ghana

1

Greece

1

Hungary

1

Iceland

2

India

4

Indonesia

5

Iraq

1

Islamic Republic of Iran

1

Ireland

2

Italy

3

Kenya

1

Korea (Republic of)

3

Lebanon

2

Lithuania

1

Malaysia

5

Mauritius

1

Mozambique

1

Nepal

2

New Zealand

5

Norway

2

Pakistan

2

Palestinian Self-Rule Areas

1

Peru

1

Philippines

4

Poland

3

Portugal

3

Romania

2

Serbia and Montenegro

1

Slovakia

1

South Africa

10

Spain

12

Sri Lanka

1

Sweden

5

Switzerland

3

China, Province of Taiwan

2

Thailand

7

The Netherlands

3

Turkey

5

Uganda

3

UK

9

Ukraine

1

USA

35

Venezuela

1

Yemen

1

Zambia

1

Zimbabwe

2

TOTAL

228

Breakdown of responses by WHO Region

WHO African Region

Frequency

South Africa

10

Uganda

3

Zimbabwe

2

Ghana

1

Kenya

1

Mauritius

1

Mozambique

1

Zambia

1

Total number of responses

20

WHO Region of the Americas

Frequency

USA

35

Canada

13

Argentina

2

Cuba

2

Antigua

1

Ecuador

1

Peru

1

Venezuela

1

Total number of responses

56

WHO South-East Asia Region

Frequency

Thailand

7

Indonesia

5

India

4

Nepal

2

Bangladesh

1

Sri Lanka

1

Total number of responses

20

WHO Eastern Mediterranean Region

Frequency

Lebanon

2

Pakistan

2

Egypt

1

Iraqn

1

Islamic Republic of Iran

1

Palestinian Self-Rule Areas

1

Yemen

1

Total per region

9

WHO Western Pacific Region

Frequency

Australia

11

Malaysia

5

New Zealand

5

Philippines

4

Republic of Korea

3

China, Province of Taiwan

2

Fiji

1

Total per region

31

WHO European Region

Frequency

Spain

12

France

10

UK

9

Belgium

5

Germany

5

Sweden

5

Turkey

5

Czech Republic

4

Italy

3

Poland

3

Portugal

3

Switzerland

3

The Netherlands

3

Croatia

2

Denmark

2

Finland

2

Iceland

2

Ireland

2

Norway

2

Romania

2

Austria

1

Estonia

1

Greece

1

Hungary

1

Lithuania

1

Serbia and Montenegro

1

Slovakia

1

Ukraine

1

Total per region

92

Countries with 5 or more responses

Country

Frequency

USA

35

Canada

13

Spain

12

Australia

11

South Africa

10

France

10

UK

9

Thailand

7

Indonesia

5

Belgium

5

Germany

5

Sweden

5

Turkey

5

Malaysia

5

New Zealand

5

Names of courses, medical specialties etc. (longer text info)

Within the regular curriculum, medical faculty

Course name

No.

Pharmacology or ‘basic pharmacology’

22

Clinical pharmacology

21

Pharmacotherapy, therapeutics, pharmacotherapeutics or ‘rational pharmacotherapy’

12

Ethics, bioethics or medical ethics

6

Rational drug use/ rational use of medicines

5

Pharmacology and toxicology

4

Personal & professional development

3

Bachelor of Medicine

2

General practice

2

Health economics for medical students

2

Pharmacology and therapeutics

2

Practice of medicine (2): managing conflicts of interests - physician and pharmaceutical industry relations (1)

2

2nd year symposium on commercialisation of medicine; 3rd year problem-based learning case on relations with pharmaceutical industry

1

Clinical epidemiology - problem-based curriculum (PBL)

1

Clinical sciences & Investigative medicine

1

Community medicine,

1

Critical appraisal

1

Critical approach to the biomedical literature

1

Degeneration and diseases of aging (Topic: effects of drug promotion on prescribing behaviour)

1

Delivery of health care

1

Development of medicines: clinical research methodology

1

Doctoring

1

Drug companies activities and medical ethics

1

Family medicine

1

Improving rational antibiotic use in Chinese hospitals

1

Information on medicines and publicity

1

Integrated in the course Medical drugs in society

1

Integrated in the problem-based curriculum

1

Issues in medicine

1

Medical personal & professional development (year 2), year 4 common programme

1

Medical sociology

1

Part of clinical discussion of 3 hours on dispensing and prescribing

1

Prescribing

1

Psychiatry clerkship (1 1/2 hr)

1

Public health

1

Scientific basis of medicine

1

Social pharmacology

1

The development of medicine

1

Use of medicines

1

Within the regular curriculum, pharmacy faculty

Course name

No.

Pharmacy practice

6

Health care ethics or pharmacy ethics

5

Pharmacy law

5

Pharmaceutical marketing; and hospital pharmacy (2); and healthcare system (1)

4

Pharmacology; 2hr drug information course re relationship with drug industry (1)

4

Clinical pharmacy; deontology and pharmaceutical legislation (1)

3

Forensic pharmacy

3

Pharmacotherapy; applied pharmacotherapeutics

3

Pharmacy - critical appraisal series

3

Pharmacy in the health care system

3

Profession of pharmacy

3

Communication skills

2

Industrial pharmacy practice; industrial pharmacy modules

2

Public health pharmacy (Year 1)

2

Social pharmacy

2

Pharmacoepidemiology and pharmacoeconomics

1

Pharmacy information systems and literature evaluation

1

Biomedical literature evaluation

 

Biopharm and drug registration

 

Community pharmacy practice, dispensing lab.

 

Drug literature evaluation

 

Drug regulation, pharmaceutics

 

Drug use, drug information, the pharmaceutical organizations and the law, economy

 

Foundations of pharmacy; issues in pharmacy (2 courses)

 

Health policy and pharmacy management, case conference on pharmacotherapy, clinical drug trials

 

Hospital pharmacy

 

Included in courses: information sources; drug policy; pharmacy & law;

 

Medicines promotion at the pharmaceutical market

 

Pharmaceutical care; pharmaceutical regulations and deontology

 

Pharmaceutical regulatory affairs (translation)

 

Pharmaco informatics (Year 2)

 

Provincial and national healthcare

 

2. Elective courses - medical faculties

Subject

No.

Clinical pharmacology

7

Pharmacology

6

Pharmaceutical marketing

2

Continuing education and information

 

Development of new drugs and healthcare products (Desarrollo de nuevos fármacos y productos sanitario)

 

Doctors and the pharmaceutical industry

 

Drug pedagogics

 

Ethics of the pharmaceutical industry

 

Family medicine electives

 

Health policy elective

 

Improving rational antibiotic use in Chinese hospitals

 

Molecules to man

 

Pharmacoeconomics

 

Pharmacoepidemiology

 

Pharmacotherapy

 

Physicians and Big Pharma

 

Promoting rational drug use (promotion included in course)

 

Sources of pharmacological information on medicines (Fuentes de información farmacologica de medicamentos)

 

Elective courses - pharmacy faculties

Subject

No

Pharmaceutical marketing

4

Hospital pharmacy

2

Pharmaceutical sales techniques; Principles of pharmaceutical marketing

2

Pharmacoepidemiology

2

Clinical pharmacy

 

Communication

 

Drug promotion

 

Drugs & behaviour (drugs & society), drug education

 

Ethics in pharmacy practice

 

Health policy analysis

 

Healthcare management

 

Information and communication

 

International health care systems

 

Intro to health care delivery

 

Management for the pharmacist

 

Non-prescription drug therapy

 

Pharmaceutical policy

 

Pharmacoeconomics

 

Pharmacy and law

 

Understanding the pharmaceutical industry (connaissance de l’industrie pharmaceutique)

 

1C. If education about drug promotion is included within residency or specialty training, which specialty/specialties - medical

Specialty

No.

Clinical pharmacology

8

All or most

5

Internal medicine

4

Pharmacology

4

Family medicine

3

General practice

2

Paediatrics

2

Psychiatry

2

Clinical pharmacology and toxicology

 

General surgery

 

Master degree

 

Medicine

 

Module on therapeutics for the national exam [module 11 - items de thérapeutique générale dans le cadre de l’examen national classant (en remplacement de l’internat]

 

Neurology

 

Obstetrics & gynaecology

 

Urology

 

Specialty or specialized training - pharmacy

Specialty

No.

Community pharmacy (includes post graduate community pharmacy training)

4

Hospital pharmacy

2

Pharmacy practice residency

2

As part of summer Practical Pharmacy training for 300 hours total period

 

Business pharmacy track

 

Clinical pharmacy

 

Drug information practice residency

 

Postgraduate level

 

Professional doctors in pharmacy and medicine

 

Other types of teaching - medical

 

No.

Community health programmes

 

Field work in clinics and hospitals

 

In the clinics and on the wards there are discussions

 

A new module for students - critical appraisal of clinical trials (nouveau module pour les étudiants du DCEM2 et 3: Lecture critique d’articles: analyse des essais thérapeutiques)

 

It sometimes is mentioned briefly in other courses

 

During critical appraisal sessions conducted in journal clubs

2

I teach at a course for students at the “biopharmaceutical science programme” - more directed at supplying Pharma with R & D professions. Course on clinical trials methodology examines evidence for various promotional statements.

 

Opportunistic discussions on ward rounds and in clinics

 

Topic is discussed during all items concerning drug choice and prescribing, as antidepressive agents, antihistaminica, antibiotics, antihypertensive agents. etc

 

Assignments to publish a drug brochure

 

Conferences arranged according to new trends and actual problems

 

Seminars

 

We issue projects on evidence based prescribing to be completed by students

 

Informally, at rounds, while doing clinics, while seeing drug reps

 

Handing out articles on relevant matters (eg recent quarrel about brand/generic ARVs)

 

Case studies following visits to doctors’ surgeries and pharmacies

 

Within short training course on promoting rational drug use

 

Included in pharmacology lectures

 

One to one on ward rounds, at clinics etc.

 

I am asked to present at Grand Rounds; I and others speak to our residents and fellows when I attend

 

On clinical rotations faculty are encouraged to address this - it is sporadic and dependent of faculty preceptor

 

I work it into all my teachings but many colleagues feel differently and either do none, or teach the opposite, i.e. that my view is paranoid or is “serving the government”

 

Via e-campus

 

Post grad course on clinical and experimental pharmacology

 

Largely the hidden curriculum; student initiatives - no free lunch speakers etc.

 

In “promoting rational drug use” courses and also courses/workshops on “drug and therapeutics committees”

 

The issues of drug promotion come up continuously during student training. I would be amazed if the students here were not very aware of the issues.

 

Not consistently. Former Merck rep discussed drug industry promotional tactics from “insider” perspective; group of students has set up similar “no free lunch” group involving one seminar (debate with medical rep)

 

Seminar on clinical pharmacology

 

At times, the subject surfaces in classes in BioEthics

 

Drug fair

 

We have a drug information centre which provides education and training to health professionals - this includes drug promotion

 

Post graduate dispensing course for doctors

 

Faculty has a student group “Students Involved in Rational Health Activity” they also have a few activities in drug promotion

 

Medical ethics - chapter on access to innovations and information (Ethique médicale; chapitre sur l’accès à l’innovation et sur l’information)

 

Through informal extracurricular evening sessions (one per semester) through other contacts within our problem-based curriculum

 

Considerable time spent educating general practitioners

 

Formation médicale continue des cardiologues

 

Also as part of drug information course - required course

 

Course on the pharmaceutical industry

 

In some lectures (other than pharmacotherapy course) I explain about drug promotions and how drug companies affect doctors to prescribe their medications

 

It is discussed when specific groups of drugs are presented e.g. SSRI or proton pump inhibitors or NSAIDs

 

I’m not clear on what question means; we integrate it into clinical pharmacology, evidence-based medicine and ethics teaching within the curriculum over the full 5 years of the B.Med programme

 

2nd year pharmacology course

 

Included in subject “clinical pharmacology” an hour or so - plus some years a seminar with the students (2hours). Use WHO video “Good morning Mrs Dealer”. Plus 3 hour bioethics for post grads

 

Pharmacology and therapeutics involve rational drug therapy and rational prescribing and understanding essential drug concept and criticism on drug combinations

 

During therapeutic teaching

 

Refer to this contentious issue during discussion on therapeutics

 

Because I was responsible for some years for drug advertising control in Lithuania and for drug information, I learn promotion praxis; during pharmacology lectures/seminars I always present cases of wrong drug promotion and familiarise students with rules

 

Intermittent lectures to interested students and residents. In addition, a module on this topic is included - but not every year - in a required course for medical students

 

Instruction in pharmacoeconomics, evidence-based medicine and medical ethics

 

Information on promotion included in “Advanced Therapeutics” Course at end of 4th year Medicine just before students write their licensing exams

 

One seminar within the speciality of family medicine

 

Occasionally during lectures of basic or clinical pharmacology

 

Course on information on medicines “cours sur l’information sur le medicament”

 

As a component of the Medical Ethics course which is compulsory for all students

 

Brief mention in Medical Pharmacology course

 

Other types of teaching - pharmacy

Within doctor’s degree (PhD)

Drug information rotation

• regular workshops, seminars, conferences, CPD/CPE(continuous pharmacy education) programmes

Drug information services, clerkship at the drug company

• eight weeks practical training course at a pharmaceutical company

• we have an elective clerkship rotation in pharmaceutical sales, taken by 2-3 students a year

• topic for master’s thesis

• 1 hour lecture in the epidemiology module for all students in third year (AP300), practicals for all students in third year (AP 301)

• professional training in a drug stores or in a pharmaceutical company

• pharmacy professional training

Mini project, survey, seminar

Through research opportunities with faculty members

Integrated into teaching of pharmaco-epidemiology, communication and conselling, etc.

A required assignment necessitating research of DTCA and considerations of the pros and cons of the practice

One of the topics students may choose for their graduation thesis is drug promotion. It is chosen every year. Last year focussed on med reps in Hungary, next year topics on comparison of advertising rules for OTCs and internet

Assignment evaluating a pharmaceutical advertisement given to students.

Main focus is determining whether or not advert is evidence-based

Critical Appraisal series is to develop students’ ability to apply research clinically, developing broad skills underpinned by healthy scepticism, e.g. “Drug Industry Insights”

Written assignment where students must critically appraise advertisements for pharmaceuticals some clinical rotations cover this material

drug promotion is taught in forensic pharmacy curriculum under the headings of drug law. Mostly it depends on the exposure and understanding of the teacher that how much he covers - usually within framework of drug law

When they are writing their theses at the end of their studies, they might take up drug promotions as part of their research (in general write about a group of drugs)

mentioned in many courses by staff who are pharmacists

1. Post information on Notice Board; 2. Part of Module in Rational Drug Management course lectures, fill out an application for registration of medicines into of our Act and related regulations. discussions on GMP, etc. and marketing etc. is done in Pharm Practice

students complete clerkship rotations during their last professional year. if they elect to do a pharmaceutical industry rotation, they are likely to learn about drug promotion

we encourage our preceptors, especially pharmaceutical companies, who accept our students for experimental learning courses, to emphasize on the topic

Seminars every week on drug promotion

• we intend to add drug promotion to future courses

• intro clinical course dealing mainly with self-treatment. this course introduces “critical appraisal” of products on market - by therapeutic class

• discussed in the drug information class, but not in great detail and is not a requirement for that class

• discussed in a required course “The US Healthcare System”

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