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The Pharmaceutical Industry in the Nursing Home: No Such Thing as a Free Lunch

Key Words: Ethics • Long-Term Care • Somatic Therapies

SIR: In recent years, the pharmaceutical industry practice of "detailing" physicians has come under increasing scrutiny. In particular, the implications of practices such as giving gifts to physicians and paying physicians to attend informational sessions have become a concern, and most medical associations have issued guidelines to address this issue.¹

The pharmaceutical industry has apparently decided to start targeting the long-term-care (LTC) market. It has recently come to our attention that, in our region, certain pharmaceutical companies' representatives have begun offering free educational seminars, complete with a complimentary lunch, for nursing home staff members. Sometimes a physician speaker, sponsored by the drug company, will present, but, more commonly, the pharmaceutical representative him/herself will present information on a new psychotropic drug or a new indication for an existing drug. There is usually no physician present at these sessions, which are targeted at nurses and nurses' aides. As a result, those most familiar with these drugs and their potential positive and negative effects are not present to provide some degree of balance to the staff who are present and who thus may come away with a very (positively) biased view of the agent being discussed. It appears that this strategy is a very deliberate one, with the goal of getting the nursing staff to approach physicians with the idea of initiating the drug being detailed. In fact, we have received phone calls from nursing homes requesting that a patient's antipsychotic medication be changed to the drug recently described at one of these "informative" luncheons. LTC staff are particularly vulnerable to these marketing approaches, because of their limited budgets for required continuing nursing education and the offer of free education (and food); they also free nursing home administrators and directors of nursing from the task of putting together educational programs themselves.

The issue of "undue influence" of the pharmaceutical industry on LTC staff seems to us to be a major problem in the offing, and we would be very interested to hear about others' experiences. We also would raise the question of what the response of The American Association for Geriatric Psychiatry (AAGP) should be to this problem. Certainly we, as individuals with a stake in our own patients' health, need to be proactive about this and educate nursing home administrators about the potential conflicts of having unbalanced presentations by pharmaceutical industry staff, and we can also offer our presence at such events, or offer to present our own, hopefully more unbiased, information.

REFERENCES

1. Wazana A: Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA 2000; 283:373-380[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wengel, S. P. Articles by Burke, W. J. Search for Related Content PubMed PubMed Citation Articles by Wengel, S. P. Articles by Burke, W. J.