Industry payments and physicians prescriptions: Effect of a payment restriction policy

What explains the well-being benefits of physical activity? A mixed-methods analysis of the roles of participation frequency and social identification

OBJECTIVE

Physical activity in a social setting is said to be associated with well-being because it provides opportunities for participants to form social relationships. However, there are inconsistent findings regarding the well-being benefits of participating in physical activity with others. To address this inconclusive evidence, we draw on the social identity approach to health and well-being to examine whether (a) the frequency of physical activity participation in a social setting and (b) the degree of social identification associated with it, have different relationships with participants' well-being.

METHODS

We implemented a two-phase, mixed-methods design with members of women's only fitness clubs in Japan. In Study 1, we collected survey responses about social identification, life satisfaction, and eudaimonic well-being from 1118 members. The survey data were combined with respondents' objective participation data from a membership database. In Study 2, we interviewed a sample of club members to understand how the nature of social relationships differed depending on the degree of their social identification.

RESULTS

Study 1 found that social identification with a fitness club, but not the frequency of attending the club for physical activity, was positively associated with members' well-being. Study 2 revealed that members with high social identification experienced more affective relationships with other members than those with medium or low identification.

CONCLUSIONS

Our research provides quantitative and qualitative evidence supporting the association between social identification and the well-being benefits of physical activity in a social setting. It confirms the predictions of the social identity approach to health and well-being, demonstrating that people enjoy well-being benefits from physical activity participation when it is internalized as a meaningful definition of self.

Geographic distribution of general industry payments to advanced-practice clinicians

Following the recent expansion of the Open Payments program to include advanced-practice clinicians (APCs) as covered recipients, we characterized the geographical distribution of general industry payments to nurse practitioners and physician assistants using the Open Payments database. The number and dollar value of payments, as well as the average and median payment amount earned per provider, varied by state. However, a significantly higher proportion of APCs received payments in states with more restrictive scope-of-practice laws. Understanding how and why payments to APCs vary by state can elucidate how industry-APC relationships are related to changing scope-of-practice and state-specific transparency/disclosure laws, informing future legislation.

What does the French public consider to be a conflict of interest for medical researchers?

Conflicts of interests have been at the core of public debate over health and medicine for decades. Social scientists have analysed the diversity of definitions of this label as well as the policies put in place to regulate the relationships between medical researchers and various actors such as private corporations. But little attention has been paid to the way the public define and use this label. In this article, we assess what the French public consider to be a conflict of interest for medical researchers. We draw on the data from a questionnaire-based survey conducted with a representative sample of the French population in December 2021 (n = 2022) where we asked respondents to decide whether different situations constituted a conflict of interest or not. These situations concerned medical researchers' relationships with economic actors but also with politicians and the media, with or without financial compensation for the researcher. We identified three main group profiles in terms of respondents' conception of what counts as a conflict of interest: i) considering that only money matters in the labelling of a given situation as a conflict of interest, ii) considering that any relationship with economic, media and political actors constitutes a conflict of interest (i.e., that medical research should be an ivory tower), and iii) indecision as to what constitutes a conflict of interest. These three groups differed in terms of social composition as well as respondents' relationships to science, politics, and the health care system.

Interaction between physicians and the pharmaceutical industry: A scoping review for developing a policy brief

Background

Payments to physicians by the pharmaceutical industry are common, but recent evidence shows that these payments influence physician prescribing behavior in the form of increased prescription of brand-name drugs, expensive and low-cost drugs, increased prescription of payer company drugs, etc. Considering that these payments increase drug costs for patients and health systems, there is a public interest in controlling them. Therefore, this study aimed to identify and propose policy options for managing physician-pharmaceutical industry interactions in the context of Iran's health system.

Methods

In the first phase, a systematic search was conducted to identify relevant policies and interventions in Web of Science, PubMed, and ProQuest databases from 2000 to 2022. Then, the opinions of the research team and an expert group (physicians, health policy and transparency experts, and industry representatives) were used to categorize the interventions and propose policy options along with their advantages, disadvantages, and implementation considerations.

Results

In the search, 579 articles were retrieved, and 44 articles were found suitable for the final analysis. Twenty-nine interventions and strategies were identified, and based on these; Five policy options were identified: prohibition, restriction, physician self-regulation, voluntary industry disclosure, and mandatory industry disclosure.

Conclusion

The proposed policies in our study include advantages, challenges, and implementation considerations based on up-to-date evidence that can help policymakers use them to manage COI in physician-pharmaceutical industry interactions in Iran's health system. A combination of measures seems to help manage COI: firstly, using self-regulating physicians and industry to institutionalize transparency, and in the next step, implementing mandatory industry disclosure policies and establishing restrictions on some financial interactions.