The University of Toronto plans to revise a course on pain management in the faculty of medicine in order to limit influence, or the perception of influence, from pharmaceutical companies. The case centres around complaints about a book that is copyrighted by Purdue Pharma that was distributed to students by one of the authors who had visited the university as a guest lecturer. The story raises questions over whether younger doctors are more willing to prescribe narcotics than more senior physicians.
From the Canadian Press:
A complaint about perceived drug industry involvement in a pain management course for medical students has prompted the University of Toronto to revamp its curriculum.
An informal inquiry into the complaint about potential conflict of interest, lodged earlier this year by an unidentified student and two doctors in the faculty of medicine, has set out clear guidelines about how the course should be taught, by whom and with what sources of funding.
The complaint centred around students being provided a book on managing chronic pain that was funded and copyrighted by the maker of the prescription pain killer OxyContin. The book had been brought in by a non-faculty lecturer with financial ties to the drug company.
In a report obtained by The Canadian Press, inquiry head Lorraine Ferris says “time is of the essence” in revising the interfaculty pain curriculum, a 20-hour course jointly taught to medical, dental, pharmacy and nursing students.
Ferris, associate vice-provost in the department of Health Sciences Policy and Strategy, said by email that she found no evidence of wrongdoing or actual conflict of interest. “However, I was troubled by the perception of conflict of interest and therefore my recommendations … addressed this issue.”
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Dr. David Mock, dean of dentistry at Canada’s largest university, said the four faculties involved in the centre are in the process of implementing the recommendations.
“I think this is a good thing,” said Mock. “I’m not looking at this as a hand-slap for the centre. I think what we’ve done is move it into the more modern governance system that we are developing at the university.
“The course will still be run by the people who know the most about the topic and that’s the people from the Centre for the Study of Pain. The course hasn’t been taken away from them.”
Ferris’s report also said the curriculum should not be “directly funded (in whole or in part) by industry donors who have, or may have, or be perceived to have financial interests in the assessment or management of pain.”
From 2002 to 2006, the pain course was funded by donations, included $117,000 in unrestricted educational grants from four drug companies — Merck-Frosst, Purdue Pharma, Pharmacia Canada and Pfizer — although they had no input into course content. Since 2007, the program has been funded solely from faculty budgets.
Mock said Purdue’s copyrighted book on pain management had been brought in by Dr. Roman Jovey, an unpaid guest lecturer and co-author of the book who left copies “for anyone to take.” Jovey, medical director for a chain of clinics called the Centres for Pain Management, is a member of Purdue’s speakers’ bureau, paid by the company to conduct workshops and lectures.
“It wasn’t distributed by the program,” Mock said of the book. “But we stopped that because, again, there’s reality and there’s appearances and it appeared as if we were pushing the books, so to speak. So we stopped doing that, we stopped before the inquiry.