Impact of continuing medical education activities conducted by pharmaceutical companies on the clinical practice of doctors of Karachi

Title: Continuing medical education is a requirement for doctors globally. Medicine is not a fixed but an evolving science, old knowledge is replaced by new. Doctors who would choose to see more patients are often hesitant to take out time to study and learn new material by themselves. CMEs are playing a very important part in doctor’s professional lives and pharmaceutical companies money has become the life-line of these CMEs. The aim of this study is to evaluate the effectiveness of such CMEs conducted by the pharmaceuticals and to assess whether they are considered ethical and professional by the physicians or not. Background: Continuing medical education is a requirement for doctors globally. Medicine is not a fixed but an evolving science, old knowledge is replaced by new. Doctors who would choose to see more patients are often hesitant to take out time to study and learn new material by themselves. CMEs are playing a very important part in doctor’s professional lives and pharmaceutical companies money has become the life-line of these CMEs. It is important to evaluate and monitor such industry funded CMEs and efforts should be made to conduct them in most ethical and professional manner. Methods: 162 Physician’s (Consultants and General Practitioners) working in Karachi were selected randomly after informed consent from a list provided by multi-national pharmaceutical companies who participated in various continuing medical education activities conducted by them. The data was collected via a self administered structured questionnaire and were analysed by using SPSS version 17. The questionnaires were filled out by the researcher on the site through interview. Results: The mean age of doctors was 47.14 ± 10.94 years 71% were male doctors and 29% were female doctors. Out of 162 subjects for 48.1% doctors the source of information about CMEs were medical representatives from pharmaceutical companies. When asked about the influence of industry-funded CMEs on their prescribing decision 66.7% doctors said sometimes, 7.4% doctors responded most of the time whereas 25.9% said that such CME activities have no influence on their prescribing decision. 67.3% doctors were of the opinion that both Scientific or education information and Product information was the main purpose and focus of CMEs. According to 80.2% doctors the information provided during CMEs programs were useful and accurate. 82.1% doctors believed that CMEs benefit them in their daily clinical practice and plays an increasingly important role in clinical education. 53.7% doctors were of the opinion that CMEs sponsored by Pharmaceutical companies are bias whereas. 46.3% doctors thought that they do not introduce bias. However 138(85.2%) doctors of the doctors said that industry-sponsored CMEs are ethical and helpful. Conclusions: Our findings showed that there is a high degree of acceptance for the involvement of the pharmaceutical industry in CME activities amongst the doctors of Karachi. Physicians do get affected by their interactions with the pharmaceutical companies when attending various CME activities and such interactions do have influence on their prescribing decision. This study clarifies the perception of clinicians about the potential bias from the commercial funding of CME activities. Most of the physicians participating in this study expressed their concern about potential bias from commercial support of CME activities, however majority of them considered this support as ethical and helpful. The participants of the study were of the opinion that clear guidelines should be made by the concerned authorities on commercial funding of CME activities and efforts should be made to make them effective as such activities benefit our society and health care profession through promoting the discovery and development of new medications and medical devices that can bring improvement and positive change in individual and public health. Key words: Continuing Medical Education (CME, Pharmaceutical companies, General Physicians, Ethic