Interactions between non-physician clinicians and industry: a systematic review

Area of Science:

• Health Policy and Management
• Clinical Practice
• Pharmaceutical Marketing

Background:

• Physician-industry interactions face increasing restrictions, shifting marketing focus to other health professionals.
• Health policy developments highlight the critical decision-making role of non-physician clinicians.
• Understanding non-physician clinician-industry relationships is crucial for patient care and ethical practice.

Purpose of the Study:

• To systematically review the types of interactions between non-physician clinicians and industry.
• To examine the implications of these interactions in clinical practice.
• To synthesize current evidence on non-physician clinician-industry engagement.

Main Methods:

• Systematic review of MEDLINE and Web of Science databases (1946-2013).
• Inclusion of Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical/occupational therapists.
• Qualitative synthesis of data from 15 studies into eight outcome domains.

Main Results:

• Non-physician clinicians regularly interact with pharmaceutical and infant formula industries, relying on representatives for practice information.
• Common interactions include receiving industry "information," attending sponsored "education," and distributing patient materials.
• Free samples are a widely approved and frequent mode of interaction, with clinicians often perceiving interactions as ethical and beneficial.

Conclusions:

• Positive attitudes toward industry interactions among non-physician clinicians suggest normalization across disciplines, despite awareness of potential bias.
• Existing industry relations policies may not adequately address non-physician clinician interactions.
• Consistent, discipline-wide industry relations policies are essential to mitigate conflicts of interest and safeguard patient care.