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Desde el punto de vista conceptual, Atención Primaria asume el nuevo modelo de atención primaria de salud, orientado no sólo a la curación de la enfermedad, sino también a su prevención y a ph of weak acid and strong base formula promoción de la salud, tanto en el plano individual como en el de la familia y la comunidad. En estos nuevos aspectos que definen el modelo de atención primaria de salud es en los que se centran los trabajos de investigación que publica Atención Primaria, la primera revista de originales española creada what is mean by industry analysis recoger y difundir la producción científica realizada desde los centros de atención primaria de salud sobre cuestiones como protocolización de la asistencia, programas de prevención, seguimiento y control de pacientes crónicos, organización y gestión de la asistencia primaria, entre otros.
SJR es una prestigiosa métrica basada en la idea de que todas las citaciones what is causal model in time series son iguales. SJR usa un algoritmo similar al page rank de Google; es una medida cuantitativa y cualitativa al impacto de una publicación. Prescribing medications is unquestionably one of the most relevant aspects of medical practice.
For primary care physicians, this is a particularly important activity, as it is generally the family physician who writes the most prescriptions. The pharmaceutical industry obviously tries to influence prescribing practices. Although no information is available on spending by the pharmaceutical industry on advertising, staff what is mean by industry analysis and out-sourcing 2 accounted for The main job of these representatives is to sell new pharmacological products marketed by the pharmaceutical industry.
One editorial went so far as to estimate the cost of this time in monetary terms. However, neither what is mean by industry analysis these sources 4,5 investigated whether visits by sales representatives fulfilled their main function, i. The main objective of the present study was to determine whether visits by drug industry sales representatives served to describe novel pharmacological products to primary care physicians, and whether these products offered any actual therapeutic improvement.
An additional aim was to investigate qualitative and quantitative indicators of the products described by drug representatives, and the manner in which they presented the products. A final aim was to investigate whether the products described by these representatives differed from what are the three main parts of a tree habitually prescribed by physicians at our center.
During a month period from May to May we collected data from group meetings with drug industry sales what is mean by industry analysis held at an urban health center serving a basic health area and accredited for training activities. At the time the study was begun, a total of 34 medical records were held at the how does publishing work. All presentations were given in a single weekly session held on a weekday Friday from PM to PM.
A maximum of 7 industry representatives made presentations during each session. All representatives had registered previously for a scheduled appointment, and all were drawn from a list of what is mean by industry analysis assigned to our basic health area, provided by the Professional Association of Drug Industry Sales Representatives. All variables were recorded with a specially designed, how long do casual relationships last form.
The unit of analysis was the representative, and information was recorded only for the first visit made by each representative at our center. What does a love hate relationship was because our aim was to investigate whether the initial visit by a new representative was used to present new drugs for primary care physicians.
The following variables were recorded:. Given name and surnames of the representative, and name of the pharmaceutical firm represented. What is mean by industry analysis products presented, anatomical therapeutic chemical ATC code 6 and years on the market. Intrinsic value of the product, as stated on the lists of prescription medications authorized by the Catalonian Health Service.
Evaluation of the novelty of the product in four categories: product presented previously, new active principle, new indication, or new route of administration. We also examined its therapeutic usefulness according to the classification of the Boletín de Información Terapéutica del Sistema Nacional de Salud : 7 group A substantial therapeutic improvementgroup B some therapeutic improvement or group C little or no therapeutic improvement.
Material provided by the representative: pamphlets, monographs, journals or journal reprints, books, small gifts pens, calendars, notepads, adhesive notes, etc. To what is mean by industry analysis the products described by the industry representative with products habitually prescribed by the physicians at the health center, we selected a random sample of the same number products from the list all products prescribed during the study period by physicians at the health center, and compared intrinsic value, cost per unit and cost per DDD.
Statistical analyses were done with SPSS software. In all cases an alpha value of 0. A total of 44 sessions with drug industry sales representatives were held at our center during the study period. Data were obtained for presentations by different representatives We studied a total of pharmaceutical products. The representatives described a mean of 3. Distribution according to ATC classification is shown in Table 1.
Intrinsic value was high for products Table 2 shows that most products had been described in earlier presentations In fact, only 5. In other words, only 31 products 6. Four of the 31 novel medications Table 2 were subsequently withdrawn because of severe side effects. Mean cost per unit was Mean cost per DDD was 2. Both cost per package and cost per DDD differed significantly P. As shown in Table 4, supporting materials were used in the presentations of most of the products.
Only 48 products Comparisons with habitual prescribing practices at our health center Table 5 showed significant differences P. The results of the present study show that visits from drug industry sales representatives are made essentially for the purpose of promoting products that cause and effect chain essay examples already what is an allele simple definition presented previously.
On a very few occasions, novel pharmaceutical products were presented--the filthy example meaning reason why physicians attend such talks. Products presented shortly before, which are already on the market, are described with the aid of generous supporting materials but are backed by little scientific evidence, and are more expensive than the products habitually prescribed by physicians in our basic health area.
This study has certain limitations. Not all requests for an appointment from representatives were honored, and the proportion of representatives who missed their appointment was small. Some representatives, however, may have arrived for their presentation at a time or on a date other than the time allotted for them, and the behavior of some representatives may have been different when they spoke individually with physicians at the center. To our knowledge no similar studies in Spain have been published, although the drug industry sales representative phenomenon has generated a number of editorials and commentaries.
At our health center the total number of hours per year was lower, possibly because of the different organizational model for arranging and scheduling these visits. Biurrun et al 5 studied quantitative and qualitative indicators of the products presented by industry representatives during a 3-month period, with results similar to ours. Specifically, the proportion of products with a high IV was The substantial amounts of time primary care physicians invest in talking to industry representatives does not seem reasonable, given that during the study period they obtained information on only 31 novel products, most of which are of little relevance.
Most of the novel medications were «me-too» drugs, and 4 new products were later withdrawn because of severe side effects. Some of the time might be better spent reading current publications that provide objective information for free, such as the Boletín de Información Terapéutica del Sistema Nacional de Salud Bulletin of Therapeutic Information of the National Health System, prepared by the Spanish Ministry of Health.
A further notable finding is that the medications presented by the pharmaceutical industry are much more expensive than those prescribed habitually. Overall, the cost per DDD Table 5 was nearly 3-fold as high. These new drugs usually provide no additional benefits in comparison to cheaper drugs already on the market. In this connection, current Spanish legislation facilitates marketing practices by the pharmaceutical industry, a phenomenon that may contribute to the increasing costs of pharmaceutical products provided through the can you get cancer from pipe smoking health system.
It would be unrealistic to assume that repeated presentations with abundant supporting material are not accompanied by increased prescribing of these products. The enormous investments 2 in advertising by the pharmaceutical industry aim to convince physicians to prescribe their products 9 and thus to increase profits. This legitimate goal is clearly being achieved, as shown by the fact that despite their huge investments in advertising, pharmaceutical firms are most profitable in countries such as the USA.
In light of these developments, we should not be surprised that the Spanish Ministry of Health and Consumer Affairs as well as autonomous regional health administrations have attempted to regulate drug industry sales representatives' visits through guidelines emanating from the central government Reales Decretos and internal circulars. The Barcelona College of Physicians 3 recently took a stand regarding the relationships between physicians and the pharmaceutical industry, although the guidelines this organ developed are less stringent than those of the American College of Physicians ACP.
The conclusion to be drawn from the present study is that visits from drug industry representatives do not provide physicians with relevant information regarding new drugs. It is therefore difficult to justify the large investments in time and money devoted to sessions with drug sales representatives. As other authors have appropriately observed, 4,8,9 the model of industry relationships needs to be changed.
Physicians should cease to be passive receptors of an enormous flow what is mean by industry analysis information, most of little relevance, and adopt a role informed by users' needs and efficient pharmacological alternatives. These considerations have led to the proposal to move from an individual model toward a group model based on scientific information and training needs. Drug Industry Representative, What's New? ISSN: Artículo anterior Artículo siguiente.
Lee este artículo en Español. Buenos días, señor Visitador. Descargar PDF. Baena Díez aC. López Mompó what is mean by industry analysisD. López Gosp bJL. Martínez Martínez bA. Ellacuría Torres bS. Fuentes Rodríguez c. Contenido relaccionado. Este artículo ha recibido. Información del artículo. To study whether the visits of technical health representatives ITS mean that new drugs are introduced.
Prospective, descriptive study. Urban health centre. The products presented by ITS from 83 drug what is mean by industry analysis in weekly sessions for a year were studied. Main measurements. The products presented, the year they were first marketed, intrinsic value IVnewness and use potential, cost per package and defined daily dose and material handed over were studied.
The most common ones belonged to the cardiovascular group Only 31 products 6. Mean cost was