A global list of pharmacy and medical schools was developed based on relevant Internet sitesi as well as information supplied by the WHO. An initial form was developed in English, French and Spanish asking whether or not the institution was educating students about drug promotion (e.g. critical evaluation and responses to promotion); if so, contact information for educators was requested. These initial requests were sent by fax to the offices of deans of medicine or pharmacy, between July 2004 and December 2004. If there was no initial response, the fax was repeated two additional times. Additionally, notices were placed on e-mail list-serves with a focus on pharmaceutical policy or drug promotion, such as e-drug, e-med, no-free-lunch, and haieuropromo, requesting contact information for those involved in education about drug promotion.
i The following websites were contacted:
Based on a series of review articles developed from the WHO/HAI drug promotion database on interactions between health professionals and the pharmaceutical industry and on educational initiatives to date, a draft questionnaire was prepared (author: BJM). This questionnaire was circulated for comment to an international team of physicians and pharmacists with experience and expertise in education on drug promotion. The questionnaire covered the following issues: amount of education, placement in the curriculum, types of promotional activities, regulatory and ethical issues covered, educational techniques, materials developed, evaluation, judgment of success and identification of barriers to success. See Appendix I for a copy of the questionnaire.
The questionnaire was produced in English and translated into French and Spanish. It was sent out by e-mail whenever possible, or by fax. The survey was carried out from January to the end of April 2005. Non-respondents received up to two follow-up questionnaires at 10-day intervals.
Responses were included if respondents stated that they educated medical or pharmacy students about drug promotion (any aspect) within the required curriculum, elective courses, specialty/residency training, and/or in other ways, such as workshops or seminars. Responses were excluded if they reported on education about how to promote products, for example within a course preparing them to work as a sales representative for a pharmaceutical company. If duplicate entries were received describing the same course provided by the same institution, the information provided was compiled into a single entry (duplicate responses excluded).
A random sample of 20% of questionnaires was checked for data entry errors. The error rate was less than 1% (0.68%) and errors were mainly concentrated on specific questions. These questions were checked and corrected, as needed, on all of the questionnaires.
The analysis of results is descriptive. Responses were classified by health profession (pharmacy or medicine) and by location within a WHO region. Exploratory chi square analysis was carried out to identify potential differences between pharmacy and medical faculty responses, using EpiInfo 2000. These differences should be interpreted as generating hypotheses for further study, rather than necessarily being indicative of broader underlying trends.