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Nothing but the Truth

Pharmaceutical representatives provide information to doctors and others about some of the most important remedies used in medicine. Doctors may change their prescribing advice based on such information, and, though the way medicines are promoted is certainly changing, information from this source probably still represents a significant influence on why doctors do things.

How do we know they tell the truth?

This is exactly what researchers at San Diego set out to do. Lunch time training conferences were held as part of the normal teaching programme - with pharmaceutical representatives occasionally giving brief presentations about their products. Talks were regularly tape recorded.

Recordings of 13 talks given by pharmaceutical company representatives were transcribed by a pharmacist who attended the meeting and statements were analysed - 106 were eligible for analysis.

For a statement to be classified as incorrect it had to meet all of three criteria:-
  • It clearly contradicted prescribing information in the Physicians' Desk Reference or literature quoted or handed out by the representative.
  • A pharmacist and doctor independently assessed the statement as incorrect.
  • A search of reference books, brochures and MEDLINE provided no support for the statement.
Statements were classified as favourable if they encouraged prescribing of the medicine, unfavourable if they discouraged prescribing or neutral if the statement was neither clearly favourable nor unfavourable.

Results

Presentations averaged 2.4 minutes (from 30 seconds to 12 minutes). In all there were 106 statements, of which 12 were inaccurate. All were favourable to the medicine being promoted.

There were 15 statements about competitors' medicines. All were accurate but none were favourable.

Comment

Is this a surprise? Perhaps not.

Is it a hard judgement? Well, the criteria for a statement to be inaccurate were harsh - so these were not trivial inaccuracies. The inaccurate statements are given in the paper - so you could judge how important they were by reading them yourself.

What would the inaccuracy rate be for academic presentation? Don't know, though these do last more than 2.4 minutes on average, and most people have sat through at least one lecture they thought was complete drivel.

Ultimately doctors themselves are responsible for judging the reliability of the medical information they use, but this paper also shows that the provision of information from pharmaceutical company representatives formed a significant portion of their information base.

Reference:

MG Ziegler, P Lew, BC Singer. The accuracy of drug information from pharmaceutical sales representatives. Journal of the American Medical Association 1995 273: 1296-8.



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