Hospital based nurses have high levels of contact with pharmaceutical and medical device industry sales personnel but have little corporate or professional guidance about managing purchasing decisions in the context of these interactions, a new study in Annals of Internal Medicine reveals.
The study of 56 nurses from four US-based acute care hospitals reported the following findings from a study done from 2012-2014:
- All nurses reported interactions with industry representatives and had an average of 13 interactions in that period
- One-on-one meetings with sales representatives were the most common form of interaction
- Nurses reported attending sponsored lunches, dinners, or events (70 per cent), receiving offers of gifts (71 per cent) or product samples (61 per cent)
- 27 per cent of nurses reported receipt of paid travel or payments for participating in market research, speakers' bureaus, or consulting activities
- Nurses reported interacting largely with the medical device industry (84 per cent), but also with the pharmaceutical (55 per cent), health technology (21 per cent), and infant formula industries (4 per cent).
"Most nurses (59 per cent) acknowledged there were benefits in working with industry representatives and more than a quarter (29 per cent) noted that it would be impossible to do their jobs without industry resources," said the paper's lead author, Dr Quinn Grundy of the University of Sydney's Charles Perkins Centre and Faculty of Pharmacy.
"For example, nurse educators coordinated in-service education with sales representatives on every newly purchased product, nurse managers relied heavily on sales representatives when selecting products for purchase, and staff nurses worked alongside sales representatives on a daily basis during surgery," she said.
However, most nurses (70 per cent) reported challenges with these relationships. Examples of the challenges with industry interactions included struggling to ensure sales representatives adhered to hospital policy, biased information sources, the introduction of unapproved devices, lack of accountability for product failure, and threats to patient safety and privacy.
Why market to nurses?
"Most study participants - 64 per cent - cited examples where nurses had influenced treatment and purchasing decisions," Dr Grundy said.
About one third of interviewed nurses (36 per cent) were standing members of institutional purchasing committees. Furthermore, interviewed industry professionals viewed nurses as a key audience because they had direct contact with industry's ultimate marketing targets - patients, prescribers and purchasers.
"The scope of practice of nurses in Australia is similar to nurses in the United States," Dr Grundy added. "They have similar decision-making and influential roles within healthcare so they are desirable marketing targets."
Medicines Australia, the pharmaceutical industry's peak body, requires member companies to publicly disclose all payments for 'educational' events - a major marketing strategy for the pharmaceutical industry.
In 2009 Medicines Australia reported that nurses were present at 26 per cent of 14,649 pharmaceutical-sponsored educational events hosted in the first 6 months of that year.