F Riese1, S Guloksuz2, C Roventa3, J D Fair4, H Haravuori5, T Rolko6, D Flynn7, D Giacco8, V Banjac9, N Jovanovic10, N Bayat11, C Palumbo12, M Rusaka13, O Kilic14, J Augėnaitė15, A Nawka16, M Zenger17, I Kekin10, P Wuyts18, E Barrett19, N Bausch-Becker20, J Mikaliūnas15, E Del Valle21, K Feffer22, G A Lomax23, J G Marques24, S Jauhar25. 1. Psychiatric University Hospital Zurich, Division of Psychiatry Research and Psychogeriatric Medicine, Lenggstr. 31, 8032 Zurich, Switzerland. Electronic address: florian.riese@bli.uzh.ch. 2. Department of Psychiatry and Psychology, Maastricht University Medical Centre, EURON, Maastricht, The Netherlands; Department of Psychiatry, Yale University, New Haven, CT, USA. 3. University Psychiatry Hospital Pr. Dr. Al. Obregia, Bucharest, Romania. 4. Kershaw Unit, Gartnavel Royal Hospital, Glasgow, United Kingdom. 5. Hospital District of Helsinki and Uusimaa, Kellokoski Hospital and National Institute for Health and Welfare, Helsinki, Finland. 6. Psychiatric Clinic, Tartu University Hospital, Tartu, Estonia. 7. Department of Psychiatry, St. Lukes Hospital, Kilkenny, Ireland. 8. Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom. 9. Clinic for Psychiatry, University Clinical Center Banjaluka, Banjaluka, Bosnia-Herzegovina. 10. Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia. 11. Arkin Psychiatric Institution, Amsterdam, The Netherlands. 12. Department of Neuroscience and Sense Organ, University of Bari, Bari, Italy. 13. Riga Stradins University, Riga, Latvia. 14. Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. 15. Vilnius University Psychiatric Clinic, Vilnius, Lithuania. 16. Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 17. Central Ostrobothnia Hospital District, Kokkola Central Hospital, Kokkola, Finland. 18. UPC KU Leuven, Leuven, Belgium. 19. Our Lady's Hospital for Children, Crumlin, Dublin, Ireland. 20. Psychiatric University Hospital Zurich, Division of Psychiatry Research and Psychogeriatric Medicine, Lenggstr. 31, 8032 Zurich, Switzerland. 21. Centre Hospitalier Universitaire de La Tronche, 38700 Grenoble, France. 22. Shalvata Mental Health Center, Hod Hashron, Israel. 23. South West London and St George's Mental Health Trust, London, United Kingdom. 24. Centro Hospitalar Psiquiatrico de Lisboa, Lisbon, Portugal. 25. Department of Psychosis Studies, Institute of Psychiatry, King's College, London, United Kingdom.
Abstract
BACKGROUND: Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees. METHODS: One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire. RESULTS: The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean)=0.92, SD=1.44, range=0-12) and most in Portugal (M=19.06, SD=17.44, range=0-100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M=3.30, SD=1.26 vs. M=2.39, SD=1.06 on a 5-point Likert scale: 1 "completely disagree" to 5 "completely agree"). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio)=1.21, 95%CI=1.12-1.30 and OR=1.18, 95%CI=1.02-1.37). CONCLUSIONS: There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
BACKGROUND: Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees. METHODS: One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire. RESULTS: The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean)=0.92, SD=1.44, range=0-12) and most in Portugal (M=19.06, SD=17.44, range=0-100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M=3.30, SD=1.26 vs. M=2.39, SD=1.06 on a 5-point Likert scale: 1 "completely disagree" to 5 "completely agree"). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio)=1.21, 95%CI=1.12-1.30 and OR=1.18, 95%CI=1.02-1.37). CONCLUSIONS: There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
Keywords:
Conflict of interest; EFPT; European Federation of Psychiatric Trainees; Industry interactions; Pharmaceutical industry; Psychiatric training