UT Medical School to Study Prescribing Practices
and Industry Influence
HOUSTON–(May 10, 2007)–This summer, The University of Texas Medical School at Houston will launch its part of a multi-center study that examines the pharmaceutical industry’s impact on the prescribing practices of physicians.
“This is one of the hottest, most controversial topics in medical education and practice today,” said Eugene Boisaubin, M.D., professor of internal medicine and principal investigator of the study at the UT Medical School. “Doctors will say they absolutely are not influenced by the pharmaceutical industry in terms of what they prescribe to their patients, but look at the drug advertisements that are on their pens or coffee mugs. This does have an impact on the decisions they make when they write a prescription, as proven by several studies.”
The UT Medical School, along with collaborators at Stanford University, the University of Southern California, the University of Pennsylvania and the University of East Carolina, will survey medical residents and faculty about prescribing influences. Some of the participating institutions also will include medical students in the study.
The American Medical Association is funding the study, “Sound Prescribing: A Lifelong Curriculum for Physicians.”
In Houston, Boisaubin and co-investigator Allison Ownby, Ph.D., assistant director of educational programs, will begin by recruiting residents to participate in an educational project.
Participants who sign consent forms for the study will initially take two surveys and watch a taped debate titled “The Controversial Role of the Pharmaceutical Industry in Medicine.” The debate, which took place in the spring at the UT Medical School, features the chief medical officer of Pharmaceutical Researchers and Manufacturers of America and the director of the Institute for the Medical Humanities at The University of Texas Medical Branch at Galveston.
Residents also will participate in online tutorials about pharmaceutical sales, drug manufacturers and prescribing practices. Toward the end of the study, the residents will be evaluated on their encounters with standardized patients, who will be instructed to request a heavily-marketed medication they saw on a television commercial.
“The residents will be tested on how they interact with the patient,” Boisaubin said. “We’re hoping to see them do a good job of engaging the patient in an informative discussion and explore the best options for treatment, rather than just acquiescing to the patient’s request.”
The UT Medical School will launch a parallel study with faculty clinicians who interact with pharmaceutical representatives in the clinics and hospitals.
The studies coincide with a national movement urging doctors to base their prescription writing on medical evidence rather than drug makers’ marketing.
Earlier this year, Community Catalyst, a health care consumer advocacy group, and the Institute on Medicine as a Profession, a research group at Columbia University, launched a national campaign calling for restrictions on the interactions between doctors and drug companies. This preceded the publication of a study in the New England Journal of Medicine which found that 94 percent of physicians had some type of relationship with the pharmaceutical industry.
According to the national survey of more than 3,100 physicians, 83 percent reported receiving food from pharmaceutical representatives and 78 percent said they had received drug samples. More than one third of the respondents received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter received payments for consulting, giving lectures or enrolling patients in trials.
Some hospitals and medical schools, including the UT Medical School, have either established guidelines or are in the process of developing policies that specifically address interactions with pharmaceutical representatives and other vendors in the health care industry.
Boisaubin recently was appointed to chair a subcommittee that is analyzing the impact of commercial influence on the medical school’s curriculum.
“Ultimately, we want to provide education that encourages better prescribing practices for physicians in training and practice,” Boisaubin said. “We want to develop evidence-based, rational practices for prescribing more effective, and perhaps less expensive, medications. We don’t want prescribing practices to be based alone on free lunches and gifts from pharmaceutical reps.”