Abstract
Background: Lawsuit settlement funds from off-label marketing of Neurontin were earmarked for clinician education on drug development, approval and marketing. Four HMORN CERTs sites, including Kaiser Permanente Colorado (KPCO), received grants.
Aims: To develop, implement, and evaluate curricula on drug marketing and prescribing based on needs assessments of prescribing clinicians (PCs) and KPCO organizational leaders.
Methods: Online interactive curricula were developed after surveys of physicians, nurse practitioners, physician assistants and KPCO organizational leaders. ‘Pharmaceuticals from Development to Practice,’ included 3 modules (4 CME credits): Off-Label Use of Pharmaceuticals, Accessing & Appraising Unbiased Drug Information, and Addressing Patient Inquiries about Specific Medications Advertised to Consumers. Modules contained didactic material, case studies incorporating heavily marketed medications, and self-reflection questions. Participants could pose questions to faculty, who responded by email. Participants were invited to a follow-up session to share learnings and interact with faculty. PCs were randomized to participate in 2 phases, the latter cohort a delayed comparison group for pre-post time-series prescribing analysis of heavily marketed medications. Other outcomes included self-reported intent to change, knowledge changes, number and descriptions of questions posed to faculty, qualitative summaries of reflection questions, and participant ratings of each module.
Results: Final sample sizes were 43 for prescribing and 47 for other outcomes. Each module had 33 to 44 participants. 14 questions were posed to faculty; 131 intent-to-change statements were generated. Nearly all participants agreed that the modules met their objectives. Over 90% of participants indicated increased knowledge on accessing/appraising drug information and off-label prescribing/promotion; 70% indicated increased comfort in addressing patient inquiries. Due to small sample size, cohorts will be combined for prescribing analysis, with participants compared to non-participants.
Conclusions: Participants valued the curricula on the impacts of pharmaceutical marketing and prescribing. Subsequent evaluation will include effect on prescribing and follow-up on intended practice changes. Additional strategies are needed to increase prescriber interest and participation in curricula on this topic.
- Received September 11, 2008.
