This post courtesy of Anne Taylor-Vaisey:

From the New England Journal of Medicine (subscription required to read the full article: Health Care Coverage and Drug Costs — The Candidates Speak Out

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This post courtesy of Anne Taylor-Vaisey:

We could all use a reminder about how to design effective written materials, patient/health-related or not. Here is a useful article from the latest issue of Disability and Rehabilitation.

ATV

Hoffmann T, Worrall L. Designing effective written health education materials: considerations for health professionals. Disabil Rehabil 2004; 26(19):1166-1173.

PURPOSE: Written health education materials can only be effective if they can be read, understood, and remembered by patients. The purpose of this article was to review the literature about features that should be incorporated into written health education materials to maximize their effectiveness, identify where there is consensus and debat! e about which features should be incorporated, and develop recommendations that health professionals can use when reviewing their existing materials and designing new materials.

METHOD: Literature review of published research and education articles.

RESULTS: There is a large number of features that need to be considered when designing written health education materials so that they are suitable for the target audience and effective. Although there is consensus about the majority of features that should be included, further research is needed to explore the contribution of certain features, such as illustrations, to the effectiveness of written materials and the effect of well-designed written materials on patient outcomes.

CONCLUSIONS: Health professionals need to provide their patients with written health education materials that are patient-orientated and designed according to the best practice principles in written health education material design.

PubMed

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As reported in an article entitled, Doctors and drug companies are locked in “vicious circle” in this issue of BMJ, an Australia-based watchdog group called Healthy Skepticism proposed “A radical new approach to paying drug companies should be introduced rewarding them for improving health rather than maximising sales” to the UK parliamentary health committee.

Dr Peter Mansfield, director of Healthy Skepticism, said in a memorandum given to the MPs that doctors and drug companies were locked in a “vicious circle,” encouraging each other to do the wrong thing.



“If companies overpromote their drugs effectively, doctors reward them via higher drug sales,” he said. “If doctors over-prescribe drugs, companies have more money for gifts and for promotion, reinforcing doctors’ beliefs that they are doing the right thing.”

This post courtesy of Anne Taylor-Vaisey:

From the October 28 issue of the New England Journal of Medicine:

D. M. Studdert, M. M. Mello, and T. A. Brennan.

Financial Conflicts of Interest in Physicians’ Relationships with the Pharmaceutical Industry  Self-Regulation in the Shadow of Federal Prosecution. New England Journal of Medicine October 28 2004;351(18):1891-1900.

The past two years have witnessed extraordinary regulatory ferment in the area of conflicts of interest involving physicians, especially conflicts arising in relationships with the pharmaceutical industry. Professional regulatory bodies, the pharmaceutical industry, and the government have all decided that physicians and drug manufacturers need stronger advice about appropriate relationships. In 2002, three leading professional organizations  the American Medical Association,1 the American College of Physicians,2 and the Accreditation Council for Continuing Medical Education3  issued or revamped guidelines regarding physicians’ interactions with drug companies. In July 2002, acting through its trade association, the Pharmaceutical Research and Manufacturers of America, the industry adopted a broad code of conduct for its constituencies.4 In April 2003, the Office of the Inspector General of the Department of Health and Human Services released a set of guidelines with which manufacturers were urged to comply in order to guard against the risk of liability.

Extract

Full text (subscription)

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After the American Society of Cataract and Refractive Surgery expressing concern over the new Standards for Commercial Support and their guidance documents, ACCME earlier this week met with officials at ASCRS. As part of the discussion, Laura Johnson, ASCRS Director of Education, says in a press release, ACCME Executive Director Murray Kopelow, MD, “agreed to hold an audio conference to clarify some of the apparent contradictions and vagaries of the implementation guidance. ASCRS takes the position that written amendments are necessary to assure that all elements of the CME community can have a common understanding of what is expected of them in dealing with conflict of interest and bias issues.”

“Our meeting with ACCME Executive Director Murray Kopelow, MD was productive and clarified the intent behind the recently Updated Standards,” said Laura Johnson, ASCRS Director of Education. “We discussed what we viewed as contradictions between the current guidance documents and their intent, and hope that those discussions will lead to written clarification of the guidance documents for implementing the Standards,” she added.

ACCME Updated Standards for Commercial support link

Identifying and Resolving Conflicts of Interest in Continuing Medical Education

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According to this article, California Governor Arnold Schwarzenegger signed into law a bill that requires pharmaceutical companies that do business in Calif. to adhere to the OIG Guidance and PhRMA Code.

Under a new state law signed in California Sept. 29 by Gov. Arnold Schwarzenegger (R), pharmaceutical companies that do business in California must implement a compliance program and specify how much promotional money they’ll spend on providers annually. With its reputation for trend setting, California’s move may spur other states to take similar actions.



The law (S.B. 1765) requires pharmaceutical producers to adopt the voluntary compliance models developed by both the HHS Office of Inspector General (OIG) and the Pharmaceutical Research and Manufacturers of America (PhRMA), their main trade group. The deadline: July 1, 2005.

The usual suspects of gifts, promotional materials, and other items that may appear to induce prescriptions are mentioned as possible violators of the federal anti-kickback law. When the terms of the two guidances conflict, companies have to comply with whichever is the strictest.

According to an analysis of the bill, the exemptions include “financial support for continuing medical education forums, and financial support for health educational scholarships if that support is provided in a manner that conforms to the OIG Guidance and the PhRMA Code.”

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This post courtesy of Anne Taylor-Vaisey:

Here’s a heads-up for some great weekend reading, if you are interested in evidence-based medicine. (And who isn’t?)

The upcoming BMJ issue for October 30 is a theme issue entitled:

Evidence Based Medicine: Does it make a difference?

BMJ October 30 2004; 329(7473)

Note: BMJ is still providing its contents at no charge, but in 2005 articles will be available by subscription only.

The links to the current issue will be active tonight (October 28); here are some highlights:

I received the following in an e-mail from a reader, who agreed to let me post this (with all identifying information taken out):

Re the new Standards for Commercial Support: We’re also cautiously optimistic as the dust begins to settle and facts replace hysteria in the provider community. Our company is a member of the North American Association of Medical Education and Communications Companies (NAAMECC), and last week we joined 47 other NAAMECC member companies in an hour-long conference call with ACCME Executive Director Murray Kopelow, MD. During the call, Dr. Kopelow provided frank responses to several dozen questions and scenarios that had been submitted by our membership in advance of the call.



Speaking for our own company, we came away with a very positive feeling about our existing policies and a fair idea of the types of adjustments we’d need to make under the new documents. Our main takeaway message was that commercially supported CME is still a viable and credible way to get education to the healthcare community, and that only the less conscientious or less knowledgeable providers would have any difficulty remaining in compliance. Having said that, it’s clear that the new requirements on identifying and resolving conflicts of interest will call for a new level of diligence–but we’re up to it.

How do you feel about the new Standards, now that ACCME has posted some additional clarifying materials on its Web site? And don’t forget to vote on our survey.

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This post courtesy of Anne Taylor-Vaisey:

For those of you interested in reading about the delivery of CE online, here is an excellent review published in the Summer 2004 edition of Journal of Continuing Education in the Health Professions (JCEHP). Susan Copley Cobb has selected and reviewed 17 studies that met her criteria for inclusion.

I have reproduced below the article’s abstract and the lessons for practice, and have provided citations for the seventeen studies, as well as links to their abstracts.

This post courtesy of Anne Taylor-Vaisey:

In case you are in the process of preparing a poster presentation (interjects Sue, or would like to be able to give good advice to your poster presenters)… Here is a useful article from the October issue of Respiratory Care. Free full text is available.

Shelledy DC. How to make an effective poster. Respir Care 2004; 49(10):1213-1216.

Abstract: Poster presentations given at scientific meetings are widely used in medicine, nursing, and allied health professions to communicate research findings. A good poster presentation can be an effective way to share the results of your research with your peers, in a collegial and non-threatening atmosphere. Feedback received during a poster session can be invaluable in refining your research and pre! paring for publication in a peer reviewed journal. A typical poster presentation follows the same format as a scientific paper. Poster sections include a title banner, the abstract, introduction, method, results, discussion, conclusions, and tables and figures. Technical details of poster production include decisions on what materials and methods to use to print and display your poster, font size, whether to use a professional graphics department for production, and cost. Presentation of your research at a professional meeting can be a rewarding experience, and is a useful step toward publishing your research in a respected science journal.

Free full text

PubMed

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