Tuesday, November 02, 2010

Industry sponsored education and adherence to evidence based practice

I just happened on a study the pharmascolds won't want you to see.

The critics of industry sponsored education are fond of citing studies demonstrating that pharmaceutical industry promotion influences doctors away from best evidence. As I once said in a Medscape Roundtable article on this subject, that research was unbalanced because it selectively looked at areas of known overuse of pharmaceuticals. The effect on attitudes and practice of promotions in areas of known underuse of evidence based treatments was ignored in this research for years.

Only very recently has research even begun to pay attention to the effects of industry promotion on areas of known underutilization. Specifically, there have been two studies now. The first one, which I have mentioned several times before in these pages, was a study on the effects of the Surviving Sepsis Campaign, one of the most maligned industry campaigns in all of medicine, showing that the campaign resulted in improved adherence to evidence based practice (and better patient outcomes to boot). The second one, the most recent one the pharmascolds won't want you to see, is this one just presented at the ACCP annual meeting. The educational activity in question was funded by Novartis. Here are the study findings:

RESULTS: Physicians who participated in CME programs were 50% more likely to provide evidence-based COPD care than those who did not participate. Furthermore, compared with non-participants, participants were more likely to correctly recognize COPD in a patient presenting with dyspnea (74% vs 94%; p=0.007), recognize that women may have a greater susceptibility than men to the toxic effects of smoking (54% vs 90%; p less than 0.001), and identify the mechanisms of action of emerging therapies (33% vs 65%; p=0.003). Participants were also twice as likely as non-participants to report complete familiarity with the GOLD guidelines for managing COPD (28% vs 14%), and less likely to cite difficulty in obtaining spirometry results as a barrier to optimal COPD care (25% vs 40%).
CONCLUSION: According to validated measurements of efficacy of CME on physician competency and performance, PCPs who participated in a half-day regional CME program on COPD diagnosis, staging, and treatment were significantly more likely than nonparticipants to deliver evidence-based COPD care.

H/T to Policy and Medicine.

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