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Relationship between paediatricians and the pharmaceutical and commercial milk formula industries: an explanatory
Mario Alejandro Leon-Ayala1, Maria Alejandra Agudelo-Velasquez1, Carlos Enrique Yepes-Delgado2,3
1Department of Pediatrics, Universidad de Antioquia, Medellin, Colombia.
Insights
Pediatricians in Colombia frequently interact with the commercial milk-formula industry, viewing these relationships as essential for continuing medical education (CME). This normalization of interaction makes the effects of industry ties less visible and fosters a sense of necessity.
Area of Science:
- Pediatric Practice
- Medical Ethics
- Pharmaceutical Industry Relations
Background:
- Understanding the complex relationships between healthcare professionals and industry is crucial for maintaining unbiased medical practice.
- The influence of industry on prescribing habits, particularly in pediatrics, warrants thorough investigation.
Purpose of the Study:
- To describe and understand the nature and impact of relationships between pediatricians and the industry in Colombia.
- To explore the factors influencing pediatricians' perceptions of industry interactions and their necessity for continuing medical education.
Main Methods:
- A mixed-methods approach combining quantitative (e-survey) and qualitative (semistructured interviews) phases.
- Quantitative analysis to identify patterns and influencing factors in pediatrician-industry interactions.
- Qualitative grounded theory to develop an explanatory theory of these relationships.
Main Results:
- Nearly all surveyed pediatricians interact monthly with industry, primarily the commercial milk-formula industry (CMFI).
- Perceptions of industry trip influence on prescribing and necessity for continuing medical education (CME) were linked to sponsorship and lack of teaching roles.
- Qualitative findings revealed normalization of interactions, dependence on industry for CME, and the Colombian health context facilitating closer ties.
Conclusions:
- Frequent pediatrician-industry interaction, especially with CMFI, is perceived as necessary for CME.
- The normalization of these relationships leads to underestimation of their effects, reinforcing their perceived necessity in pediatrics.
Objective:
To describe and understand relationships between paediatricians and industry in Colombia.
Methods:
Mixed methods study composed of three phases: quantitative (cross-sectional study, e-survey to paediatricians) describing interaction patterns and evaluating the factors that explain the perceived need for industry visits to health services and their influence through multivariate analyses; qualitative (grounded theory study, semistructured interviews) to create an explanatory theory; and an integrative phase (mixed methods explanatory study).
Results:
We surveyed 218 paediatricians (mean age, 45.2 years), nearly all of whom interacted with industry monthly, mainly with the commercial milk- formula industry (CMFI). Sponsored trips to attend conferences and not having teaching activities were associated with a perception of the potential effects of the trips on prescribing practices. Moreover, being sponsored for an international trip was associated with the perception of indispensability of industry visits for maintaining continuing medical education (CME). In the qualitative phase, four phenomena emerged; two related to the quantitative findings: 'Paediatrician's dependence on industry for CME', and 'Colombian health context facilitates a closer relationship between paediatricians and industry'. Two emerged as explaining factors: 'Normalisation of paediatrician-industry interaction' and 'Paediatrician's prescriptive power: mediator between their conflict of interest with industry and patients'. The integration showed how the qualitative phase explained the quantitative findings.
Conclusions:
Most paediatricians frequently interact with industry, mainly with the CMFI, and this is perceived as necessary for CME. The normalisation of the paediatrician-industry interaction leads to the underestimation and invisibility of its effects, which fosters the notion of its necessity for the paediatric field.
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