The Inclusion of Nurses in Pharmaceutical Industry–Sponsored Events

Abstract

disease has remained relatively stable from 2009 through 2014, although the prevalence of individuals reporting adherence to a gluten-free diet has more than tripled (0.52% in 2009-2010 to 1.69% in 2013-2014).Part of what may be driving this gluten-free diet trend is simply a belief, fueled by marketing and media, that these foods are healthier. However, surveys suggest that many individuals who adhere to a gluten-free diet believe that the exclusion of gluten has resulted in subjective health benefits from weight loss to reduced symptoms of inflammation and gastrointestinal distress. 3,4 Because a gluten-free diet may have negative social, financial, and health repercussions, it is important for clinicians to understand whether, in most cases, it is the elimination of the protein gluten that is responsible for symptom improvement or whether following a gluten-free diet is simply a marker of other dietary choices that are creating positive effects. 5 Not all research has found that individuals who adhered to a gluten-free diet resulted in subjective health benefits. A recent 2-year prospective study 6 from Italy suggests that something other than gluten itself is resulting in self-reported health benefits. Researchers enrolled all consecutive patients with gluten-related symptoms, and after those with celiac disease or wheat allergy were eliminated, only 7.5% experienced any change of symptoms with a gluten-free diet. Studies such as this raise the question of what other than gluten might explain the symptomatic improvement experienced among those following a gluten-free diet.One explanation is that it is not the gluten but the grain itself. Researchers in Australia found that that the fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and insoluble fiber that are found in glutencontaining foods may be responsible. FODMAPS and insoluble fiber increase the osmotic pressure in the large intestine and promote bacterial fermentation, which results in gas production and abdominal bloat. In a controlled, crossover study 7 of patients with irritable bowel syndrome, a diet low in FODMAPs effectively reduced these symptoms; in a related study, 8 patients who improved while following a low-FODMAP diet experienced no exacerbation of symptoms when gluten was introduced.Another explanation is that gluten elimination may accompany other dietary trends that are associated with improved symptoms. For example, adherents to the popular Paleolithic and autoimmune protocol diets might also report being on a gluten-free diet. 9 There is a debate about whether these diets, which promote eating unprocessed foods that were available in preagricultural times while avoiding grains, oils, and legumes, offer any health advantage over other whole food diets (such as the Mediterranean diet). Nonetheless, some have argued that simply eliminating highly processed foods (including highly processed gluten-containing foods) might result in an improved sense of well-being.Following a gluten-free diet likely means d...

A comparison of educational events for physicians and nurses in Australia sponsored by opioid manufacturers

“…Nurses, which comprise the largest proportion of health professionals across health systems, frequently interact with industry representatives and also report receiving payments and gifts [21]. In Australia, 40% of pharmaceutical-industry sponsored educational events included nurses; in contrast, 21% of sponsored events included primary care physicians [22]. Through promotional campaigns, pharmaceutical companies seek not only to increase their market share, but also to expand their market through promoting awareness, screening, assessment of conditions for which the drug is indicated and expanding the indications for the drug, particularly to new settings and populations [23] Nurses play a key role in assessing pain, and administering opioid medications and particularly, medications prescribed 'as needed,' across multiple healthcare settings including acute care, primary care, and long term care.…”

The Ethics of Emergent Health Technologies: Implications of the 21st Century Cures Act for Nursing

“…At this point, there are no constraints on the way combination products can be marketed to nurses. Nurses are frequently targeted by pharmaceutical sales personnel and often influence prescribing activities, a phenomena well-documented in research examining nurse-industry relations (Grundy, Fabbri et al, 2016;Grundy & Malone, 2017;Jutel & Menkes, 2008). Since combination products may be marketed through existing pharmaceutical sales channels, there is an increased need for nursing education about the appropriateness and risks surrounding their uptake within health systems.…”

Constructing a problem and marketing solutions: A critical content analysis of the nature and function of industry‐authored oral health educational materials

“…Industry sustains its presence in clinical settings through the provision of educational materials including research syntheses, product information sheets, brochures, posters and teaching materials, which nurses rely on to support clinical and purchasing decisions and for their own practice supports (Grundy, 2016, 2018; Jutel & Menkes, 2009). Outside of hospital settings, nurses rely on industry as a source of continuing education at conferences and sponsored events, such as drug dinners (Grundy, 2018; Grundy et al, 2013, 2016; Madden, 2012; Madden & Stark, 2019).…”