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Updated: Aug 21, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
A prospective before-and-after trial of an educational intervention about pharmaceutical marketing
Sacha Agrawal1, Inderpal Saluja, Janusz Kaczorowski
1Postgraduate Education, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 4th Floor Fontbonne Bldg., 301 James South, Hamilton, Ontario L8P 3B6, Canada. agrawas@mcmaster.ca
Purpose:
There is increasing evidence that physicians may be compromised by their interactions with the pharmaceutical industry. The authors aimed to develop and determine the effect of an educational intervention to inform family medicine residents about pharmaceutical marketing.
Method:
Confidential, self-administered questionnaires were administered to family medicine residents at McMaster University, Hamilton, Canada, immediately before and after a two-part, 2.5-hour educational intervention. The curriculum consisted of (1) a faculty-led debate and discussion of a systematic review of physician-pharmaceutical industry interactions, and (2) an interactive workshop that included a presentation highlighting key empirical findings, a video illustrating techniques to optimize pharmaceutical sales representatives' visits, and small- and large-group problem-based discussions. Residents were asked about their attitudes toward five marketing strategies: drug samples, industry-sponsored continuing medical education, one-on-one interactions with sales representatives, free meals, and gifts worth less than CAN $10.
Results:
A total of 37 residents responded to both questionnaires. After the intervention residents had more cautious attitudes, rating marketing strategies on a five-point Likert scale as less ethically appropriate (-0.41, p < .05) and less valuable to patients or useful to the resident (-0.39, p < .05), and reporting less intention to use them in the future (-0.44, p < .01).
Conclusion:
This intervention appears to have promoted more cautious attitudes toward pharmaceuticals marketing. Its long-term sustainability and effect on behavior remain unknown.
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