TABLE 1

Summary of Articles Included in Review

Study (Year)SitePopulationn/NaStudy DesignMethodsInterventionKey Findings
Impact of regulatory policies
    Brotzman and Mark18 (1993)United StatesFP residents265/378Cross-sectionalSurveyResidents of programs with no regulatory policies were more likely to view PR interaction as beneficial and view gifts as appropriate
    McCormick et al13 (2001)Ontario, CanadaIM residents205/299Retrospective cohortSurveyPostpolicy residents were less likely to find PR information beneficial and reported lower levels of PR contact after training
Impact of educational interventions
    Vinson et al19 (1993)Columbia, MOFirst- and second-year medical students131/215Nonrandomized, controlled trialSurvey50-min lecture/discussion on pharmaceutical industry marketing practicesThose in the intervention group were less accepting of marketing practices after the intervention
    Shaughnessy et al20 (1995)Harrisburg, PAFP residents12/12Pre-postSurveyLecture/discussion on pharmaceutical industry marketing practices and evaluation of actual PR presentationsPostintervention residents did not change their belief that PRs play an important teaching role but were more likely to believe that PRs can influence prescribing behavior
    Anastasio and Little21 (1996)North CarolinaFP residents29/30Pre-postSurveyEducational seminar about 1-on-1 PR interaction with role playing and feedbackResidents reported increased confidence ratings for all 10 interaction goals
    Hopper et al22 (1997)Detroit, MIIM faculty and residents28/31 (residents)Pre-postSurvey40-min lecture/discussion addressing ethical and marketing issues for pharmaceutical industryPostintervention residents demonstrated increased belief that PRs can be unethical, that gifts are inappropriate, and that prescribing could be influenced
    Wilkes and Hoffman23 (2001)Los Angeles, CAThird-year medical students120/136Pre-postSurveyMock 20-min PR presentation with discussion and demonstration of evidence-based search toolsIntervention increased belief that PR interactions are problematic
    Agrawal et al24 (2004)Hamilton, Ontario, CanadaFP residents37/72Pre-postSurvey2.5-h workshop on pharmaceutical industry marketing tactics; included faculty-led debate and problem-based discussions of commonly encountered scenariosPostintervention residents reported less favorable attitudes toward all forms of marketing and reported less intention to use them in the future
    Randall et al25 (2005)ConnecticutPsychiatry residents32/48Nonrandomized, controlled trialSurvey1-h seminar on PR interaction and group-discussion vignettes of typical interactionsThose in the intervention group reported reduced acceptance of noneducational gifts, but no change was seen in acceptance of education gifts or gifts of benefit to patients; also, no difference in attitudes toward PRs was reported
    Stanley et al26 (2005)United KingdomThird-year medical students23/29Pre-postSurveyDidactic teaching module about drug discovery and development formulated in partnership with a pharmaceutical company; intervention included 15 h of personal study timeStudent knowledge of drug development increased after the intervention, and students held a more positive view of the pharmaceutical industry (significant change)
    Wofford and Ohl27 (2005)North CarolinaThird-year medical students75/75Pre-postSurvey90-min workshop about interactions with PRs; role playing of a typical PR office encounterPerceived educational value of PR information increased after intervention; perceptions of bias in PR information decreased, but perceived degree of influence on prescribing increased
    Schneider et al28 (2006)Chicago, ILIM residents161/189Nonrandomized, controlled trialSurveyInteractive workshop including review of literature and guidelines and 3 video demonstrations of routine resident-PR interactionsThose in the intervention cohort were more likely to rate only 1 of the “appropriate” pharmaceutical industry interactions as less appropriate (“lunch at noon conference”); several inappropriate gifts were perceived as more inappropriate by those in the intervention cohort, but results were not significant
  • IM indicates internal medicine; FP, family practice.

  • a Presented as the number of respondents per the number of subjects available.