Medical students and residents who report higher levels of pharmaceutical marketing interactions were more likely to prescribe brand name drugs and less likely to rely on evidence-based treatment options, according to a study in JAMA Internal Medicine.
The study surveyed first- and fourth-year medical students and third-year residents, a random selection of at least 14 at each level per school.
“There is little active marketing or commercial outreach for generic drugs or behavioral interventions,” the study said. “This imbalance in information appears to crowd out more evidence-based choices.”
The study also revealed where trainees get their prescription drug information. Nearly one in five residents reported getting basic information about drugs from pharmaceutical sales representatives and other industry sources, while fewer medical students said the same. Over the course of medical training, the study found an increased use of peer-reviewed journal articles and clinical practice guidelines.
A large fraction of residents still reported common use of unfiltered sources, such as Google or Wikipedia, for prescription drug information. The study said this “is concerning because these sources are conduits for inaccurate or biased information. Even PDA and iPhone applications, generally considered to be more reliable resources, can present industry bias through paid advertisements.”
Growing concerns that financial relationships with pharmaceutical companies negatively affect quality and cost of patient care have led medical schools to implement policies limiting these interactions with students and faculty. In an Editor’s Note that accompanied the study, Joseph S. Ross, MD, said medical schools and teaching hospitals should continue to adopt policies that restrict industry interactions.
“Medical school and postgraduate training are times of rapid, intensive clinical learning, when professional identities are formed, and the ‘habits’ of clinical practice are begun,” Dr. Ross writes. “It is becoming increasingly clear that restricting these interactions during medical school and postgraduate training leads to higher-quality, more evidence-based prescribing among physicians, which is good for the profession, for patient care and for the public’s trust in medicine.”
