Zusammenfassung
Hintergrund/Ziele: Sponsoring von ärztlicher Fort- und Weiterbildung durch die Pharmaindustrie steht zunehmend in der Kritik. Diese Arbeit gibt eine Übersicht über internationale Studien mit Schwerpunkt auf Einstellungen und Verhalten von Ärzten zum Themengebiet.
Methode: Systematische Literaturrecherche in PubMed für die letzten 10 Jahre. Eingeschlossen wurden 22 englisch- und deutschsprachige Primärstudien sowie eine Sekundärarbeit.
Ergebnisse: Entgegen der Selbstwahrnehmung vieler Ärzte beeinflusst Pharmasponsoring ihre Eintellungen und ihr Verhalten. Häufig kommen Mediziner schon während ihres Studiums in Kontakt mit der Pharmaindustrie und betrachten während ihrer weiteren Laufbahn Zuwendungen von der Industrie als Selbstverständlichkeit. Es gibt unterschiedliche Ansätze, um z.B. mit Schulungsmaßnahmen gegenzusteuern, wobei nur wenig aussagekräftige Daten zu Effektivität und Nachhaltigkeit vorliegen.
Diskussion: Folgende Kernziele für die Fort- und Weiterbildung zeichnen sich ab: (1) Reduktion der Abhängigkeit der Fort- und Weiterbildung von der Pharmaindustrie, wozu eine (selbst)kritische Überprüfung der bestehenden Finanzierungs- und Kostenstrukturen gehört. (2) Wo Pharmasponsoring stattfindet, sollten verbindliche Regeln gelten. Hier steht die praktische Umsetzung bestehender Empfehlungen z. B. der Bundesärztekammer im Mittelpunkt. (3) Erhöhung der Sensibilität und Kompetenz von Ärzten im Umgang mit der Pharmaindustrie. Schulungsmaßnahmen sollten frühzeitig (im Medizinstudium) einsetzen und kontinuirlich die Weiter- und Fortbildung begleiten. Die Tauglichkeit von Schulungsmaßnahmen sollte unter Alltagsbedingungen überprüft werden.
Abstract
Background: Pharmaceutical industry sponsored medical education has increasingly been criticized. This paper provides an overview of international studies focussing on physicians' behaviour and attitudes towards sponsored medical education.
Methods: Systematic literature review (past 10 years, English and German). 22 primary studies, as well as one secondary study were included.
Results: In contrast to many physicians`own perception, pharmaceutical industry sponsorship does affect their behaviour and their attitudes. Frequently, doctors-to-be already have contact to the pharmaceutical industry during their medical studies. In their later career they tend to take gifts from the pharmaceutical industry for granted. There are a range of different educational approaches in order to go against this. However, data on their effectiveness and sustainability is scarce.
Discussion: The following major targets for medical education have emerged: (1) Decreasing the dependency of medical education and training which implies a critical evaluation of existing funding and cost structures. (2) Where pharmaceutical industry sponsored medical education takes place, binding regulations should be used. This implies the implementation of already existing recommendations, e.g. of the German Medical Association. (3) Increasing the awareness and competence of physicians when dealing with the pharmaceutical industry. The related education should start early during university studies and continue during all phases of on-the-job training and practice. The efficiency of educational interventions should be monitored in the daily routine conditions.
Schlüsselwörter
Ärztliche Fortbildung - Pharmaindustrie - Interessenskonflikte
Key words
medical education - drug industry - conflict of interest
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Korrespondenzadresse
PD Dr. N. Schneider
Medizinische Hochschule Hannover
Institut für Epidemiologie
Sozialmedizin und Gesundheitssystemforschung
Carl-Neuberg-Str. 1
30627 Hannover
Email: schneider.nils@mh-hannover.de
