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Research ArticleResearch

Drug samples in family medicine teaching units: a cross-sectional descriptive study

Part 1: drug sample management policies and the relationship between the pharmaceutical industry and residents in Quebec

Caroline Rhéaume, Michel Labrecque, Nadine Moisan, Jacky Rioux, Émilie Tardieux, Fatoumata Binta Diallo, Marie-Thérèse Lussier, Andréa Lessard, Roland Grad and Pierre Pluye
Canadian Family Physician December 2018; 64 (12) e531-e539;
Caroline Rhéaume
Clinical researcher in the Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec and in the Department of Family Medicine and Emergency Medicine at Laval University in Quebec.
MD PhD CCFP
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Michel Labrecque
Professor Emeritus in the Department of Family Medicine and Emergency Medicine at Laval University.
MD PhD CCFP FCFP
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Nadine Moisan
Pharmacist, a clinical teacher, and Professor in the Department of Family Medicine and Emergency Medicine at Laval University.
MSc
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Jacky Rioux
Research assistant in the Department of Family Medicine Emergency Medicine at Laval University at the time of the study.
MA
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Émilie Tardieux
Research assistant in the Department of Family Medicine Emergency Medicine at Laval University at the time of the study.
MD
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Fatoumata Binta Diallo
Research coordinator in the Équipe de recherche en soins de première ligne of the Centre intégré de santé et de services sociaux de Laval and at the Cité de la Santé Family Medicine Teaching Unit.
PhD
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  • For correspondence: fabinta2{at}gmail.com
Marie-Thérèse Lussier
Full Professor in the Department of Family Medicine and Emergency Medicine at the University of Montreal in Quebec, a member of the Équipe de recherche en soins de première ligne du Centre intégré de santé et de services sociaux de Laval, Director of the University of Montreal Primary Care Research Network, Regional Network Director for the Canadian Primary Care Sentinel Surveillance Network in Quebec, and a teacher and practising physician at the Cité de la Santé Family Medicine Teaching Unit.
MD MSc CCFP FCFP
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Andréa Lessard
Clinical scientist in the Department of Family Medicine and Emergency Medicine at the University of Sherbrooke in Quebec and at the Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean in Quebec.
MD MSc CCFP
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Roland Grad
Family physician in the Herzl Family Practice Centre in Montreal and Associate Professor in the Department of Family Medicine at McGill University.
MD CM MSc CCFP FCFP
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Pierre Pluye
Associate Professor in the Department of Family Medicine at McGill University.
MD PhD
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Tables

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    Table 1.

    Response rate to the questionnaire and proportion of HCPs using drug samples in the 33 FMTUs that had drug samples available, by university

    UNIVERSITYNO. OF QUESTIONNAIRES DISTRIBUTEDQUESTIONNAIRES COMPLETED, N (%)*DRUG SAMPLE USERS, N (%)†
    Laval University430368 (86)217 (59)
    McGill University187104 (56)62 (60)
    University of Montreal407294 (72)224 (76)
    University of Sherbrooke17093 (55)76 (82)
    Total1194859 (72)579 (67)
    • FMTU—family medicine teaching unit, HCP—health care professional.

    • ↵* Embedded Image = 89.36, P < .001.

    • ↵† Embedded Image = 33.80, P < .001.

    • View popup
    Table 2.

    Existence of written policies on drug samples in the FMTUs and HSSCs in Quebec and drug sample users’ knowledge of these policies, by university: Correct answers are in bold. Not all percentages add to 100 owing to rounding and not all respondents answered all questions.

    UNITWRITTEN POLICY*EXISTENCE OF A POLICY ACCORDING TO DISPENSERS
    IN FMTU, N (%)IN HSSC, N (%)
    IN FMTUIN HSSCYESNODO NOT KNOWYESNODO NOT KNOW
    Laval University
      • FMTU-1YesYes4 (21)5 (26)10 (53)10 (53)3 (16)6 (32)
      • FMTU-2YesNo2 (17)4 (33)6 (50)1 (8)3 (23)9 (69)
      • FMTU-3NoYes3 (19)7 (44)6 (38)7 (44)1 (6)8 (50)
      • FMTU-4NoYes1 (4)9 (36)15 (60)4 (16)5 (20)16 (64)
      • FMTU-5YesYes21 (64)3 (9)9 (27)13 (39)0 (0)20 (61)
      • FMTU-6YesYes6 (27)7 (32)9 (41)3 (14)2 (9)17 (77)
      • FMTU-7NoNo1 (5)5 (26)13 (68)0 (0)2 (11)17 (89)
      • FMTU-8NoYes6 (38)3 (19)7 (44)9 (56)1 (6)6 (38)
      • FMTU-9NoNo0 (0)6 (50)6 (50)0 (0)3 (25)9 (75)
      • FMTU-10NoYes2 (6)8 (26)21 (68)3 (10)1 (3)27 (87)
      • FMTU-11YesNo1 (50)0 (0)1 (50)0 (0)0 (0)2 (100)
      • FMTU-12NoNo2 (22)4 (44)3 (33)1 (11)4 (44)4 (44)
      • TotalNANA49 (23)61 (28)106 (49)51 (24)25 (12)141 (65)
    University of Montreal
      • FMTU-13†YesYesNANANANANANA
      • FMTU-14†NoNoNANANANANANA
      • FMTU-15YesYes1 (10)5 (50)4 (40)3 (30)0 (0)7 (70)
      • FMTU-16YesYes4 (67)0 (0)2 (33)2 (33)0 (0)4 (67)
      • FMTU-17NoYes1 (7)4 (29)9 (64)3 (21)1 (7)10 (71)
      • FMTU-18NoNo0 (0)13 (46)15 (54)0 (0)8 (29)20 (71)
      • FMTU-19NoYes1 (14)4 (57)2 (29)4 (57)0 (0)3 (43)
      • FMTU-20YesYes4 (13)7 (23)19 (64)1 (3)1 (3)28 (93)
      • FMTU-21YesNo1 (5)12 (60)7 (35)0 (0)3 (15)17 (85)
      • FMTU-22NoYes0 (0)8 (38)13 (62)0 (0)3 (14)18 (86)
      • FMTU-23NoYes2 (10)9 (43)10 (48)0 (0)1 (5)20 (95)
      • FMTU-24†NoNoNANANANANANA
      • FMTU-25YesNo5 (21)5 (21)14 (58)3 (13)2 (8)19 (79)
      • FMTU-26NoYes2 (10)10 (50)8 (40)3 (15)2 (10)15 (75)
      • FMTU-27YesYes4 (17)7 (30)12 (52)5 (22)1 (4)17 (74)
      • FMTU-28†NoNoNANANANANANA
      • TotalNANA25 (11)84 (38)115 (51)24 (11)22 (10)178 (80)
      • FMTU-30YesYes2 (13)5 (33)8 (53)0 (0)3 (20)12 (80)
      • FMTU-31NoNo0 (0)13 (48)14 (52)0 (0)4 (15)22 (85)
      • FMTU-32NoNo0 (0)4 (40)6 (60)0 (0)3 (30)7 (70)
      • FMTU-33†NoNoNANANANANANA
      • FMTU-34NoNo0 (0)2 (100)0 (0)1 (50)0 (0)1 (50)
      • TotalNANA2 (3)27 (44)32 (52)1 (2)10 (17)49 (82)
    University of Sherbrooke
      • FMTU-35†NoYesNANANANANANA
      • FMTU-36NoNo2 (12)10 (59)5 (29)1 (6)4 (24)12 (71)
      • FMTU-37NoYes1 (6)6 (33)11 (61)2 (11)1 (6)15 (83)
      • FMTU-38†NoNoNANANANANANA
      • FMTU-39NoYes5 (31)1 (6)10 (63)6 (38)1 (6)9 (56)
      • FMTU-40NoNA‡1 (4)6 (24)18 (72)0 (0)5 (24)16 (76)
      • FMTU-41†NoNoNANANANANANA
      • FMTU-42†NoYesNANANANANANA
      • TotalNANA9 (12)23 (30)44 (58)9 (13)11 (15)52 (72)
    Overall totalNANA85 (15)195 (34)297 (51)85 (15)68 (12)420 (73)
    • FMTU—family medicine teaching unit, HSSC—health and social services centre, NA—not applicable.

    • * Based on the survey of HSSCs, FMTU directors, and drug sample managers.

    • ↵† Health care professionals in FMTUs with no drug samples available were not invited to complete the users’ questionnaire.

    • ↵‡ There was no HSSC associated with this FMTU in New Brunswick, as HSSCs do not exist in this province.

    • View popup
    Table 3.

    Existence and drug sample users’ knowledge of policies regarding relationships between the pharmaceutical industry and residents in the FMTUs in Quebec, by university: Correct answers concerning policies are in bold; residents reporting contact with pharmaceutical representatives in the FMTUs despite policies against it are in bold and italic; percentages do not equal 100 owing to rounding.

    UNITEXISTING POLICY ACCORDING TO FMTU DIRECTOREXISTING POLICY ACCORDING TO USERS,* N = 579CONTACT ALLOWED ACCORDING TO POLICYINTERACTION WITH PHARMACEUTICAL REPRESENTATIVES ACCORDING TO RESIDENTS, N = 182
    YES, N (%)NO, N (%)DO NOT KNOW, N (%)YES, N (%)NO, N (%)
    Laval University
     • FMTU-1No0 (0)10 (53)9 (47)Yes3 (75)1 (25)
     • FMTU-2No2 (15)6 (46)5 (38)Yes1 (33)2 (67)
     • FMTU-3No4 (25)4 (25)8 (50)No0 (0)1 (100)
     • FMTU-4No2 (8)6 (24)17 (68)No1 (8)11 (93)
     • FMTU-5No2 (6)9 (27)22 (67)Yes0 (0)9 (100)
     • FMTU-6No1 (5)12 (55)9 (41)Yes1 (17)5 (83)
     • FMTU-7No3 (16)7 (37)9 (47)Yes0 (0)3 (100)
     • FMTU-8No3 (19)3 (19)10 (63)Yes0 (0)2 (100)
     • FMTU-9No0 (0)3 (25)9 (75)Yes0 (0)5 (100)
     • FMTU-10No4 (13)6 (19)21 (68)Yes3 (27)8 (73)
     • FMTU-12No2 (22)3 (33)4 (44)YesNA†NA†
     • TotalNA24 (11)69 (32)124 (57)NA9 (16)47 (84)
     • FMTU-13‡YesNANANAYesNANA
     • FMTU-14‡NoNANANANoNANA
     • FMTU-15Yes3 (30)2 (20)5 (50)Yes2 (67)1 (33)
     • FMTU-16Yes5 (83)1 (17)0 (0)Yes0 (0)2 (100)
     • FMTU-17No2 (14)2 (14)10 (71)Yes2 (33)4 (67)
     • FMTU-18No4 (14)11 (39)13 (46)Yes12 (92)1 (8)
     • FMTU-19No2 (29)2 (29)3 (43)NoNA†NA†
     • FMTU-20No3 (10)5 (17)22 (73)No1 (9)10 (91)
     • FMTU-21Yes7 (35)8 (40)5 (25)No1 (14)6 (86)
     • FMTU-22No4 (19)6 (29)11 (52)No0 (0)6 (100)
     • FMTU-23No4 (19)8 (38)9 (43)No0 (0)8 (100)
     • FMTU-24‡NoNANANAYesNANA
     • FMTU-25Yes15 (63)1 (4)8 (33)No1 (11)8 (89)
     • FMTU-26No4 (20)7 (35)9 (45)NoNA†NA†
     • FMTU-27Yes10 (43)2 (9)11 (48)Yes8 (80)2 (20)
     • FMTU-28‡NoNANANANoNANA
     • TotalNA63 (28)55 (25)106 (47)NA27 (36)48 (64)
    McGill University
     • FMTU-29No0 (0)1 (14)6 (86)No0 (0)4 (100)
     • FMTU-30No3 (20)4 (27)8 (53)No1 (9)10 (91)
     • FMTU-31No0 (0)11 (38)18 (62)Yes0 (0)9 (100)
     • FMTU-32No3 (30)1 (10)6 (60)Yes0 (0)1 (100)
     • FMTU-33‡YesNANANANoNANA
     • FMTU-34Yes1 (50)0 (0)1 (50)No0 (0)2 (100)
     • TotalNA7 (11)17 (27)39 (62)NA1 (4)26 (96)
    University of Sherbrooke
     • FMTU-35‡NoNANANANoNANA
     • FMTU-36No3 (18)6 (35)8 (47)No3 (75)1 (25)
     • FMTU-37No8 (47)3 (18)6 (35)Yes3 (75)1 (25)
     • FMTU-38‡NoNANANANoNANA
     • FMTU-39No4 (25)2 (13)10 (62)No0 (0)3 (100)
     • FMTU-40Yes2 (8)6 (24)17 (68)Yes1 (8)12 (92)
     • FMTU-41‡NoNANANAYesNANA
     • FMTU-42‡YesNANANAYesNANA
     • TotalNA17 (23)17 (23)41 (55)NA7 (29)17 (71)
    Overall totalNA111 (19)158 (27)310 (54)NA44 (24)138 (76)
    • FMTU—family medicine teaching unit, HCP—health care professional, NA—not applicable.

    • ↵* Includes responses from all dispensers (residents and teachers).

    • ↵† No residents answered this question.

    • ↵‡ The HCPs were not invited to answer the questionnaire as there were no samples available in their FMTUs.

    • View popup
    Table 4.

    Opinion of HCPs about hypothetical implementation of policies by family medicine departments regarding the use and management of drug samples, and the relationships between the pharmaceutical industry and residents: N = 859.

    OPINIONHYPOTHETICAL IMPLEMENTATION OF A POLICY BY THE FAMILY MEDICINE DEPARTMENTS REGARDING …
    USE AND MANAGEMENT OF DRUG SAMPLES, N (%)RELATIONSHIP BETWEEN PHARMACEUTICAL INDUSTRY AND RESIDENTS, N (%)
    Very favourable287 (34)292 (36)
    Favourable347 (41)303 (37)
    Neither favourable nor unfavourable158 (19)161 (20)
    Unfavourable51 (6)47 (6)
    Very unfavourable9 (1)19 (2)
    Total852* (100)822† (100)
    • HCP—health care professional.

    • ↵* 7 participants did not answer the question.

    • ↵† 37 participants did not answer the question.

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Canadian Family Physician: 64 (12)
Canadian Family Physician
Vol. 64, Issue 12
1 Dec 2018
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Drug samples in family medicine teaching units: a cross-sectional descriptive study
Caroline Rhéaume, Michel Labrecque, Nadine Moisan, Jacky Rioux, Émilie Tardieux, Fatoumata Binta Diallo, Marie-Thérèse Lussier, Andréa Lessard, Roland Grad, Pierre Pluye
Canadian Family Physician Dec 2018, 64 (12) e531-e539;

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Drug samples in family medicine teaching units: a cross-sectional descriptive study
Caroline Rhéaume, Michel Labrecque, Nadine Moisan, Jacky Rioux, Émilie Tardieux, Fatoumata Binta Diallo, Marie-Thérèse Lussier, Andréa Lessard, Roland Grad, Pierre Pluye
Canadian Family Physician Dec 2018, 64 (12) e531-e539;
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