News in brief - Feb. 13, 2006

Prominent physicians call for an end to all drug company gifts - JCAHO seeks to improve drug safety - Company discussed telling physicians about defibrillator problem earlier

Prominent physicians call for an end to all drug company gifts

Marketing dollars from drug and medical device companies are compromising the medical profession and jeopardizing patient safety, a group of physician leaders say, and it must stop if doctors want to preserve their scientific and professional integrity and keep patients safe.

A working group of physicians and academic leaders, including Jordan Cohen, MD, president of the Assn. of American Medical Colleges, and Jerome Kassirer, MD, former editor of the New England Journal of Medicine, say academic medical centers should:

Replace free drug samples with a voucher system for low-income patients.
Distribute industry money for CME through a central office at each institution.
Ban all faculty from industry speakers bureaus.
Prohibit open-ended industry grants to faculty.
Ensure more transparency in faculty research relationships with drug and device makers by posting faculty consulting and research contracts on a public Web site.

The group laid out its recommendations for tighter conflict of interest controls in the Jan. 25 Journal of the American Medical Association.

The group concludes that if medicine follows the recommendations, outside regulation of the medical profession will ease, and physicians will write prescriptions based on evidence, not from a sense of reciprocity.

JCAHO seeks to improve drug safety

The Joint Commission on Accreditation of Healthcare Organizations issued an alert that urges physicians and others to increase attention to making sure patients' medications are properly transferred when they move from one care setting to another, or one practitioner to another.

Patients may receive duplicative medications, incompatible drugs or wrong dosages if medication isn't transferred properly with the patient. In 2005, more than 2,000 voluntary reports of medication reconciliation errors were received by United States Pharmacopeia, a group that sets standards for drugs.

To cut error risk, health professionals should put the list of drugs in a visible place in a patient's chart and include information about dosages, drug schedules, immunizations and drug allergies. They also should give each patient a complete list of medications that he or she will take after being discharged, as well as instructions on how long to take any new drugs.

Company discussed telling physicians about defibrillator problem earlier

Guidant Corp. considered warning physicians about malfunctions of some its heart defibrillators sooner than the July 2005 recall of more than 100,000 devices, according to internal company documents released Jan. 19 in a Texas product liability lawsuit.

The documents show that some officials recommended telling doctors about the failures in January 2005, while others opposed the suggestion. Judge Jack Hunter of the 94th District ordered that the records be disclosed after The New York Times and plaintiff attorney Bob Hilliard requested access to them. Hilliard, representing two patients in the first trial against Guidant, said in a statement that the documents "directly affect the public health and safety and Guidant has wrongfully attempted to hide them from the public's view." The recalled defibrillators have been linked to seven deaths.

An independent panel of medical experts established by Guidant in August 2005 is expected to release a report in March with recommendations for how and when to communicate with doctors and patients about device malfunctions. The Heart Rhythm Assn. said it also plans to issue a similar report in May.

Indianapolis-based Guidant did not comment on the suit. The trial, in Nueces County, Ind., is set for Feb. 20.