Soft targets: nurses and the pharmaceutical industry

This article was just published in PLoS Medicine [Open Access]:

Jutel A, Menkes DB. Soft targets: nurses and the pharmaceutical industry. PLoS Medicine 2008; 5(2):e5.  PDF
Excerpt: [The prescription pharmaceutical] industry has been robustly critiqued in the medical literature for exploiting patients and doctors using a range of techniques: direct-to-consumer advertising (DTCA), sponsored teaching materials, advertising in professional media, research funding, ghost writing, gifts, free meals, and travel.
Conclusion: The nursing literature has yet to pay much attention to the expansive reach of the pharmaceutical industry into the nursing profession. In this article, we examine some of the key literature on the influence of drug companies upon nurses, consider the limitations of this literature, and define a strategy for heightening awareness and strengthening the skills of nurses to manage the impact of commercial interests.
Conclusion: The pharmaceutical industry recognises nursing influence on medical prescribing and identifies nurses as a marketing target. The industry has had its eye on nurses and nurse practitioners for over a decade [64], and is heavily invested in wooing them]. Unfortunately, its success in this area has been at the expense of the health budget, evidence-based care, and nursing integrity. All three can and must be reclaimed.


Chiropractic manipulation: reasons for concern?

Check out this report of three cases, published recently in Clinical Neurology and Neurosurgery:
Gouveia LO, Castanho P, Ferreira JJ, Guedes MM, Falcão F, e Melo TP. Chiropractic manipulation: reasons for concern? Clin Neurol Neurosurg 2007 Dec;109(10):922-5.

Abstract: Chiropractic’s popularity is rising among the general population. Moreover, few studies have been conducted to properly evaluate its safety. We report three cases of serious neurological adverse events in patients treated with chiropractic manipulation. The first case is a 41 years old woman who developed a vertebro-basilar stroke 48 h after cervical manipulation. The second case represents a 68 years old woman who presented a neuropraxic injury of both radial nerves after three sessions of spinal manipulation. The last case is a 34 years old man who developed a cervical epidural haematoma after a chiropractic treatment for neck pain.

In all three cases there were criteria to consider a causality relation between the neurological adverse events and the chiropractic manipulation. The described serious adverse events promptly recommend the implementation of a risk alert system.

Author affiliation: Department of Neurology, Hospital de Santa Maria, Av. Prof Egas Moniz, 1649-035 Lisbon, Portugal.