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Published Online, 26 May 2009, www.theannals.com, DOI 10.1345/aph.1M027.
The Annals of Pharmacotherapy: Vol. 43, No. 6, pp. 1057-1063. DOI 10.1345/aph.1M027
© 2009 Harvey Whitney Books Company.
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MEDICINE, LAW, AND ETHICS

"But Doctors do it...": Nurses' Views of Gifts and Information from the Pharmaceutical Industry

Annemarie Jutel, RN PhD

Associate Professor, Otago Polytechnic, Dunedin, New Zealand

David B Menkes, MD PhD FRANZCP

Associate Professor of Psychiatry, Waikato Clinical School, University of Auckland, Hamilton, New Zealand

Reprints: Dr. Jutel, Otago Polytechnic, Private Bag 1910, Dunedin 9054, New Zealand, fax +64-3-471-6870, ajutel{at}vodafone.co.nz

BACKGROUND: Most nurses, like their physician counterparts, lack education regarding pharmaceutical marketing strategies, and little is known of their beliefs and practices regarding this industry. Nurses are increasingly targeted by pharmaceutical companies as they become more involved in prescription and as policies restrict pharmaceutical companies' contact with physicians.

OBJECTIVE: To assess nurses' beliefs and reported practices concerning pharmaceutical marketing and sponsorship strategies.

METHODS: We conducted parallel Web- and paper-based surveys of a sample of senior registered nurses employed by government-funded health boards in 2 regions of New Zealand to explore their contact with the pharmaceutical industry as well as their beliefs and practices regarding information, gifts, and sponsorship provided by pharmaceutical companies. Returns were tested using Fisher's exact test to determine consistency in response between regions. Results for key outcome variables, including attitude toward the value of industry-derived information, were analyzed by region and in aggregate.

RESULTS: Most nurses had contact with pharmaceutical sales representatives (69/106), accepted gifts from representatives (79/105), and believed information from the pharmaceutical industry probably improved their practice (71/106). Half believed that they would be able to detect misleading information if it were present, and 35% believed that accepting gifts and sponsorship was ethically acceptable. We found positive associations between the belief that information from the industry improved practice and reported acceptance of conference funding (OR 3.63; 95% CI 1.41 to 11.55), free food (OR 3.24; 95% CI 2.03 to 7.55), or gifts (OR 3.52; 95% CI 1.38 to 8.95). Nurses generally acknowledge the presence of pharmaceutical marketing in the hospital and the ethical challenges it presents; nonetheless, they also generally accept marketing gifts and may underestimate both the ethical challenges and their own susceptibility to persuasion.

CONCLUSIONS: Given the increasing role that nurses may play in pharmaceutical marketing strategy, the profession should consider its position vis-à-vis the industry.

Key Words: nursing, pharmaceutical marketing

Published Online, May 26, 2009. www.theannals.com, DOI 10.1345/aph.1M027





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