Inadequate conflict of interest policies at most French teaching hospitals: A survey and website analysis


Autoři: Christian Guy-Coichard aff001;  Gabriel Perraud aff002;  Anne Chailleu aff003;  Véronique Gaillac aff004;  Paul Scheffer aff005;  Barbara Mintzes aff006
Působiště autorů: AP-HP St Antoine Hospital, Paris, France aff001;  Faculty of Medicine, Brest, France aff002;  Chair of Formindep, Paris, France aff003;  Hôpital Sainte-Anne, Paris, France aff004;  Sciences of Education Department, Paris 8 University, Saint-Denis, France aff005;  Faculty of Pharmacy, Charles Perkins Centre, The University of Sydney, Sydney, Australia aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224193

Souhrn

Background

There are 32 teaching hospitals in France, including 30 University hospitals and two Regional teaching hospitals. Teaching hospitals have three roles: health care provision, training of healthcare professionals, and medical research. These roles lead to frequent interactions with pharmaceutical and medical device companies, inevitably raising risks of conflicts of interests. Therefore, policies to manage conflict of interests (COI) are crucial. This study aims to examine COI policies in French teaching hospitals.

Methods

All French teaching hospitals (n = 32) were included in this study. All hospitals websites were screened for institutional COI policies and curriculum on COI, using standardized keyword searches. More data were collected through a questionnaire addressed to each chief executive officer (CEO) of the teaching hospital. We used predefined criteria (n = 20) inspired by similar surveys on COI policies in French, US and Canadian medical schools, with some additions to reflect the local hospital context. A global score for each hospital, ranging from 0 to 60 (higher scores denoting stronger policies) was calculated by summing points obtained for each criterion.

Results

All 32 hospitals had websites; 21 hospitals listed policies or regulations on their websites or provided them on request. In December 2017, 17 (53.1%) had rules and regulations for some items only, four of which (12.5%) have considered implementing a policy, and only two (6.3%) have begun implementation. 15 (46.9%) had no evidence of COI policies and a null score. The maximum score was 24 out of 60.

Conclusion

This is the first systematic assessment of COI policies in teaching hospitals in France. Such policies are needed to protect patients, clinicians and students from undue commercial influence. Despite public and political pressure for better management of COI, few teaching hospitals have implemented comprehensive and protective policies, and some hospitals lacked policies altogether. These results highlight the need for greater attention to management of COI within teaching hospitals. One potential solution would be to integrate COI policies into hospital accreditation procedures, in order to ensure a baseline of management at all teaching hospitals.

Klíčová slova:

France – Health care policy – Health economics – Medical devices and equipment – Medical education – Medicine and health sciences – Public policy – Procurement


Zdroje

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