Regulación de la publicidad de alimentos y bebidas dirigida a la población infantil: el derecho a la información.

Objetivo. Documentar la evolución de los marcos reguladores de la publicidad de alimentos y bebidas no alcohólicas (PABNA) dirigida a la población infantil (PI) en México. Material y métodos. Revisión documental de las leyes, reglamentos y lineamientos encargados de regular la PABNA publicados en el Diario Oficial de la Federación (DOF) desde 1926 hasta 2016. Resultados. Se revisaron 18 documentos del DOF, se identificaron ventajas y limitaciones que tienen los marcos reguladores respecto a la PABNA dirigida a la PI y cómo se ha adecuado la regulación a los cambios en los medios de comunicación. Conclusiones. Es necesario implementar una regulación estricta sobre la PABNA dirigida a la PI, la cual evite mensajes que promuevan el consumo de productos de baja calidad nutrimental, relacionados con el incremento de prevalencias de sobrepeso, obesidad y enfermedades crónicas.

[Strategies to foster an adequate compromise of the pharmacist with respect to over the counter medicines' advertisement.] / Estrategias para fomentar un adecuado compromiso del farmacéutico con respecto a la publicidad de medicamentos de venta libre.

The advertisement has a great influence on the public and, in over the counter medicines (OTC), it can generate health risks on the population if it is misregulated. The aim of this work is to analyze and disclose strategic viable actions emerged from a forum debate during an online course for fostering the pharmacist's compromise related to OTC advertisement. Methods: A content analysis was carried on, grouping by themes and categories the opinions of community pharmacists participating in a forum debate about OTC advertisement. Two audiovisual advertisement pieces were analyzed as triggers of discussion. Results: Sixty-five professionals participated in 3 groups of debate, and 103 opinions were collected. Among individual strategies, to guarantee the attention by a pharmacist was highlighted when health conditions or the use of medicines are consulted about. Other strategies include denouncing to the ANMAT the advertisements that do not comply with the norms, procuring a better regulation and assuming a critical posture. Within the collective strategies, including pharmacists in the evaluation committee of advertisement of ANMAT and furthering norms to reassess the role of the pharmacist and the community pharmacy in minor illnesses were stressed. Conclusion: The contribution of the community pharmacists allows disposing a set of professional strategies, both individuals and collectives, to promote a rational use of OTC for the patients and the community.

INTRODUCCIÓN: la publicidad ejerce una influencia muy importante sobre el público y, en el caso de los medicamentos de venta libre (MVL), puede generar riesgos en la salud de la población si no es adecuadamente fiscalizada. OBJETIVO: El objetivo de este trabajo es analizar y divulgar acciones estratégicas viables surgidas de la discusión en un foro de debate de un curso online, para fomentar el compromiso del farmacéutico ante la publicidad de MVL. MÉTODO: se realizó un análisis de contenido, agrupando por temas y categorías los aportes de los farmacéuticos comunitarios participantes en un foro de debate sobre publicidad de MVL. Como elemento disparador del debate, se analizaron 2 piezas publicitarias audiovisuales. RESULTADOS: participaron 65 profesionales en 3 grupos de debate y se efectuaron 103 aportes. Dentro de las estrategias individuales se destacan la de garantizar la atención por un farmacéutico ante consultas sobre problemas de salud o sobre el uso de estos medicamentos. Otras estrategias incluyen denunciar ante la ANMAT las publicidades que no cumplan con las normativas vigentes, solicitar mejor fiscalización y asumir una postura crítica. Dentro de las estrategias colectivas se destacan: incluir a farmacéuticos en la comisión evaluadora de publicidad de la ANMAT e impulsar normativas para revalorizar el rol del farmacéutico y la farmacia comunitaria frente a los trastornos menores.C CONCLUSIONES: la contribución de los farmacéuticos comunitarios permite disponer de un set de estrategias profesionales individuales y colectivas para promover un uso más racional de los MVL por parte de los pacientes y la comunidad.

Support to woman/nourisher in the advertising pieces of the World Breastfeeding Week. / Apoios à mulher/nutriz nas peças publicitárias da Semana Mundial da Amamentação.

OBJECTIVE:: to unveil the support to woman/nourisher in the advertisements of the World Breastfeeding Week. METHOD:: This is a descriptive, exploratory, documentary, qualitative study. Since the collection until the analyses of these advertisements, we adopted the methodological steps of Gemma Penn, based on the semiology of Roland Barthes. The results were interpreted by the theory of Social Network of Sanícola and of the five types of support: companionship, emotional, instrumental, informational, and self-supportive. RESULTS:: we identified actors of the social network of the woman/nourisher in nine advertisements of the 22 world breastfeeding weeks. In five of them, partner, grandmother, and brother showed emotional and companionship support to breastfeeding. We observed self-support in three posters; instrumental support in one; and informational support in none. CONCLUSION:: the support unraveled in only five advertisements included: emotional, companionship, instrumental, and self-supportive. In the others, there was no support. The set of supports was not revealed in any of them.

Apoios à mulher/nutriz nas peças publicitárias da Semana Mundial da Amamentação / Apoyos a la mujer/nutriz en las piezas publicitarias de la Semana Mundial de la Lactancia Materna / Support to woman/nourisher in the advertising pieces of the World Breastfeeding Week

RESUMO Objetivo: desvendar os apoios da rede social da mulher/nutriz nas peças publicitárias da Semana Mundial da Amamentação. Método: estudo descritivo, exploratório, documental, qualitativo. Desde a coleta até a análise dessas peças, foram adotados os passos metodológicos de Gemma Penn, fundamentados na semiologia de Roland Barthes. Os resultados foram interpretados pela teoria da Rede Social de Sanícola e dos cinco tipos de apoio: presencial, emocional, instrumental, informativo e autoapoio. Resultados: em nove peças publicitárias das 22 semanas mundiais da amamentação, identificou-se/identificaram-se ator(es) da rede social da mulher/nutriz. Em cinco delas, companheiro, avó e irmão demonstraram apoio emocional e presencial à amamentação. Percebeu-se o autoapoio em três cartazes; o apoio instrumental, em um cartaz; e o apoio informativo, em cartaz algum. Conclusão: os apoios desvendados em apenas cinco peças publicitárias incluíram: emocional, presencial, instrumental e autoapoio. Nas demais, não havia apoio. Em nenhuma delas, o conjunto dos apoios foi revelado.

RESUMEN Objetivo: desvelar los apoyos de la red social de la mujer/nutriz en las piezas publicitarias de la Semana Mundial da Lactancia Materna. Método: estudio descriptivo, exploratorio, documental, cualitativo. Desde la reunión hasta el análisis de esas piezas, se adoptaron los pasos metodológicos de Gemma Penn, fundamentados en la semiología de Roland Barthes. Los resultados fueron interpretados por la teoría de la Red Social de Sanícola y de los cinco tipos de apoyo: presencial, emocional, instrumental, informativo y auto-apoyo. Resultados: en nueve piezas publicitarias de las 22 semanas mundiales de la lactancia materna, seidentificó/se identificaron actor(es) de la rede social de la mujer/nutriz. En cinco de ellas, compañero, abuelo y hermano demostraron apoyo emocional y presencial a la lactancia materna. El auto-apoyo se vio en tres carteles; el apoyo instrumental, en un cartel; y el apoyo informativo, en ningún cartel. Conclusión: los apoyos desvelados en solo cinco piezas publicitarias incluyeron: emocional, presencial, instrumental y auto-apoyo. En las demás, no había apoyo. El conjunto de los apoyos no se reveló en ninguna de ellas.

ABSTRACT Objective: to unveil the support to woman/nourisher in the advertisements of the World Breastfeeding Week. Method: This is a descriptive, exploratory, documentary, qualitative study. Since the collection until the analyses of these advertisements, we adopted the methodological steps of Gemma Penn, based on the semiology of Roland Barthes. The results were interpreted by the theory of Social Network of Sanícola and of the five types of support: companionship, emotional, instrumental, informational, and self-supportive. Results: we identified actors of the social network of the woman/nourisher in nine advertisements of the 22 world breastfeeding weeks. In five of them, partner, grandmother, and brother showed emotional and companionship support to breastfeeding. We observed self-support in three posters; instrumental support in one; and informational support in none. Conclusion: the support unraveled in only five advertisements included: emotional, companionship, instrumental, and self-supportive. In the others, there was no support. The set of supports was not revealed in any of them.

Self-Regulation of Beer Advertising: A Comparative Analysis of Perceived Violations by Adolescents and Experts.

AIMS: We assessed the impact of the 2010 revisions to Brazil's self-regulatory alcohol marketing code using expert and adolescent raters. METHODS: Five popular TV beer ads were selected. Ads were rated based on the 2010 Brazilian self-regulatory marketing code. The expert group (N = 31) represented health-related professions; the adolescent group (N = 110) were public high school students. RESULTS: At least 1 ad violated 11 of 17 guidelines included in the study. Ratings by experts and adolescents were similar. Both found violations in all sections of the self-regulatory code, but significant group differences were seen in applying the section that prohibits the promotion of excessive alcohol consumption, with experts identifying more violations than adolescents. CONCLUSION: Beer ads in the sample systematically violated the self-regulatory standards for alcohol advertising in Brazil according to both experts and youth. Public policies for more effective restrictions and prohibitions in alcohol ads should be considered.

[Cigarette labeling policies: current situation in Latin America and the Caribbean]. / Políticas de etiquetado en los paquetes de cigarrillos: situación actual en América Latina y el Caribe.

In 2002, Brazil became the first country in the region to implement pictorial health warning labels on cigarette packages. Since the adoption of the FCTC/WHO in 2005, nine more countries adopted pictorial labels and six passed legislation that is pending of implementation. The message content and the picture style vary across countries. Seventeen countries have banned brand descriptors and nine require a qualitative label with information on constituents and emissions. Since 2005, important progress has been achieved in the region. However, countries that have ratified the FCTC have not yet implemented all the recommendations of Article 11 Guidelines.

Políticas de etiquetado en los paquetes de cigarrillos: situación actual en América Latina y el Caribe / Cigarette labeling policies: current situation in Latin America and the Caribbean

En 2002, Brasil se convirtió en el primer país de la región en implementar etiquetas de advertencias sanitarias con pictogramas en los paquetes de cigarrillos. Desde la adopción del CMCT de la OMS en 2005, otros nueve países adoptaron advertencias con pictogramas y seis más aprobaron legislación cuya implementación está pendiente. El contenido del mensaje y el estilo del pictograma varían entre los países. Diecisiete países prohibieron descriptores de marca y nueve requieren una advertencia cualitativa con información de constituyentes y emisiones. Un importante progreso se ha alcanzado en la región desde 2005. Sin embargo, los países ratificantes del CMCT aún no han implementado todas las recomendaciones de las Directrices del Artículo 11.

In 2002, Brazil became the first country in the region to implement pictorial health warning labels on cigarette packages. Since the adoption of the FCTC/WHO in 2005, nine more countries adopted pictorial labels and six passed legislation that is pending of implementation. The message content and the picture style vary across countries. Seventeen countries have banned brand descriptors and nine require a qualitative label with information on constituents and emissions. Since 2005, important progress has been achieved in the region. However, countries that have ratified the FCTC have not yet implemented all the recommendations of Article 11 Guidelines.

[Panaceas disseminated over the Internet and vulnerable patients: how to check a market of illusions?]. / Panacéias disseminadas pela Internet e pacientes vulneráveis: como conter um mercado de ilusões?

This article discusses the proliferation of medical quackery and fraud appearing and disappearing daily on the Internet. The customers of these scams, made vulnerable by disease or the prospect of death, use the Internet to buy products that would probably be ignored in other contexts. This vulnerability is linked to strenuous physical demands that compromise the ability to make decisions. The attempt to control the phenomenon of fraud as strictly rational, without taking into account the vulnerability of consumers who have little to lose and not considering their demands for comprehensive care, can lead to disappointing results, since these nostrums seem to be filling the gaps left by health care structures that have been insensitive to the immaterial nature of human fears.

Panacéias disseminadas pela Internet e pacientes vulneráveis: como conter um mercado de ilusões? / Panaceas disseminated over the Internet and vulnerable patients: how to check a market of illusions?

O presente artigo discute a proliferação de curas e terapias fraudulentas que surgem e evanescem cotidianamente na Internet. A clientela dessas fraudes, vulnerabilizada pela doença e pela perspectiva da morte, utiliza a Internet para adquirir produtos que seriam possivelmente ignorados em outros contextos. Tal vulnerabilidade se liga a contingências físicas desgastantes que comprometem a capacidade de decisão. A tentativa de controlar o fenômeno das fraudes de forma estritamente racional, sem levar em conta a vulnerabilidade desse consumidor que pouco tem a perder e sem considerar suas demandas de integralidade, pode conduzir a resultados desapontadores, já que as panacéias parecem estar preenchendo os lapsos deixados por estruturas assistenciais que têm sido insensíveis à imaterialidade dos medos humanos.

This article discusses the proliferation of medical quackery and fraud appearing and disappearing daily on the Internet. The customers of these scams, made vulnerable by disease or the prospect of death, use the Internet to buy products that would probably be ignored in other contexts. This vulnerability is linked to strenuous physical demands that compromise the ability to make decisions. The attempt to control the phenomenon of fraud as strictly rational, without taking into account the vulnerability of consumers who have little to lose and not considering their demands for comprehensive care, can lead to disappointing results, since these nostrums seem to be filling the gaps left by health care structures that have been insensitive to the immaterial nature of human fears.

[Drug advertising and promotion: regulations and extent of compliance in five Latin American countries]. / Publicidad y promoción de medicamentos: regulaciones y grado de acatamiento en cinco países de América Latina.

OBJECTIVE: To analyze differing regulations regarding drug promotion, and the extent of compliance as seen in samples of advertising directed to the public in Argentina, Colombia, Ecuador, Nicaragua, and Peru. METHODS: A total of 683 pieces of promotional material on display in health facilities, pharmacies, and on the street were collected, 132 of which were randomly selected for analysis. The regulations governing pharmaceutical advertising, taken from official websites and interviews with regulatory officials and Ministry of Health staff in the five countries covered, were reviewed, along with their adherence to the ethical criteria of the World Health Organization (WHO). The contents of the materials in the sample were evaluated to determine their degree of compliance with national regulations and WHO recommendations on drug promotion. RESULTS: The countries have regulations incorporating WHO ethical criteria. Over 80% of the material analyzed included the indications for the drug, while over 70% omitted information on adverse effects. Fifty percent of the advertisements for over-the-counter (OTC) drugs on display in pharmacies listed indications not approved by the relevant health authority. In advertising in pharmacies, the risks from inadequate information were not found to differ significantly for OTC or prescription medications. Compared with materials provided in health facilities, the relative risk of the absence of information on dosage in the material distributed in pharmacies was 2.08 (confidence interval 95% 1.32-3.39). CONCLUSIONS: Although regulations on drug promotion and advertising in the five countries studied generally incorporate the WHO recommendations, promotional materials often fail to reflect the fact.

Publicidad y promoción de medicamentos: regulaciones y grado de acatamiento en cinco países de América Latina / Drug advertising and promotion: regulations and extent of compliance in five Latin American countries

OBJETIVO: Analizar las distintas regulaciones sobre promoción de fármacos y su grado de acatamiento reflejado en piezas publicitarias expuestas al público en Argentina, Colombia, Ecuador, Nicaragua y Perú. MÉTODOS: Se recogieron 683 piezas promocionales expuestas en establecimientos de salud, farmacias y en la vía pública, de las cuales 132 piezas seleccionadas al azar fueron objeto de análisis. Se examinaron las regulaciones sobre publicidad farmacéutica -incluidas sus coincidencias con los criterios éticos de la Organización Mundial de la Salud (OMS)- tomadas de los sitios web oficiales y mediante entrevistas con los responsables de los organismos regulatorios y ministerios de salud de los cinco países del estudio. Se evaluaron los contenidos de los materiales de la muestra para determinar su grado de acatamiento respecto a las regulaciones nacionales y las recomendaciones sobre promoción de medicamentos de la OMS. RESULTADOS: Los países cuentan con regulaciones que incorporan los criterios éticos de la OMS. Más de 80 por ciento de las piezas analizadas incluían las indicaciones del fármaco y más de 70 por ciento omitían información sobre efectos adversos. Cincuenta por ciento de los anuncios de medicamentos de venta libre (MVL) expuestos en farmacias incluían indicaciones no aprobadas por la autoridad sanitaria correspondiente. En los anuncios expuestos en farmacias, no se hallaron diferencias significativas entre los riesgos de la información inadecuada con relación a su condición de venta (MVL o medicamentos de venta con prescripción médica). El riesgo relativo de ausencia de información sobre posología fue de 2,08 (intervalo de confianza de 95 por ciento 1,32-3,39) en las piezas distribuidas en farmacias, comparadas con las expuestas en establecimientos de salud. CONCLUSIONES: Si bien en general los cinco países del estudio incorporan en sus regulaciones sobre promoción y publicidad de medicamentos las recomendaciones de la OMS, con frecuencia dichas ordenanzas no se reflejan en los contenidos de las piezas promocionales.

OBJECTIVE: To analyze differing regulations regarding drug promotion, and the extent of compliance as seen in samples of advertising directed to the public in Argentina, Colombia, Ecuador, Nicaragua, and Peru. METHODS: A total of 683 pieces of promotional material on display in health facilities, pharmacies, and on the street were collected, 132 of which were randomly selected for analysis. The regulations governing pharmaceutical advertising, taken from official websites and interviews with regulatory officials and Ministry of Health staff in the five countries covered, were reviewed, along with their adherence to the ethical criteria of the World Health Organization (WHO). The contents of the materials in the sample were evaluated to determine their degree of compliance with national regulations and WHO recommendations on drug promotion. RESULTS: The countries have regulations incorporating WHO ethical criteria. Over 80 percent of the material analyzed included the indications for the drug, while over 70 percent omitted information on adverse effects. Fifty percent of the advertisements for overthe-counter (OTC) drugs on display in pharmacies listed indications not approved by the relevant health authority. In advertising in pharmacies, the risks from inadequate information were not found to differ significantly for OTC or prescription medications. Compared with materials provided in health facilities, the relative risk of the absence of information on dosage in the material distributed in pharmacies was 2.08 (confidence interval 95 percent 1.32-3.39). CONCLUSIONS: Although regulations on drug promotion and advertising in the five countries studied generally incorporate the WHO recommendations, promotional materials often fail to reflect the fact.

Analysis of advertising material distributed through pharmacies and drugstores.

A documental analysis was conducted to evaluate advertising material distributed through pharmacies and drugstores according to their compliance with Resolutions n. 102/2000 and 96/2008 of the Collegiate Board of Brazil's National Agency for Sanitary Surveillance. Brochures distributed through five pharmacies and drugstores in the city of Tubarão, Southern Brazil, were collected between May and November 2008. The 17 analyzed brochures advertised 2,444 products, of which 680 were medicines. Of these, 13.7% were controlled drugs, half of them had no registration number with the Ministry of Health and 77.9% had a registration number that did not match. Information on drug indications and safety were omitted. The results showed that the drug advertising materials were not in accordance with the aforementioned resolutions.

[Psychoactive drug advertising: analysis of scientific information]. / Propagandas de medicamentos psicoativos: análise das informações científicas.

OBJECTIVE: According to the World Health Organization, medicinal drug promotion should be reliable, accurate, truthful, informative, balanced, up-to-date and capable of substantiation. The objective of the present study was to review psychoactive drug advertisements to physicians as for information consistency with the related references and accessibility of the cited references. METHODS: Data was collected in the city of Araraquara, Southeastern Brazil, in 2005. There were collected and reviewed 152 drug advertisements, a total of 304 references. References were requested directly from pharmaceutical companies' customer services and searched in UNESP (Ibict, Athenas) and BIREME (SciELO, PubMed, free-access indexed journals) library network and CAPES journals. Advertisement statements were checked against references using content analysis. RESULTS: Of all references cited in the advertisements studied, 66.7% were accessed. Of 639 promotional statements identified, 346 (54%) were analyzed. The analysis showed that 67.7% of promotional statements in the advertisements were consistent with their references, while the remaining was either partially consistent or inconsistent. Of the material analyzed, an average 2.5 (1-28) references was cited per advertisement. In the text body, there were identified 639 pieces of information clearly associated with at least one cited reference (average 3.5 pieces of information per advertisement). CONCLUSIONS: The study results evidenced difficult access to the references. Messages on efficacy, safety and cost, among others, are not always supported by scientific studies. There is a need for regulation changes and effective monitoring of drug promotional materials.

["When the ad is good, the product is sold." The MonitorACAO Project and drug advertising in Brazil]. / "Quando o anúncio é bom, todo mundo compra." O Projeto MonitorACAO e a propaganda de medicamentos no Brasil.

This paper presents an analysis on drug advertising in Brazil, based on the final report of the MonitorACAO Project, by the group from the Universidade Federal Fluminense, Niterói, Rio de Janeiro. Due to a partnership between the university and the National Agency for Health Surveillance (ANVISA), drug advertisements were monitored and analyzed for one year, according to the methodology defined by the Agency. The samples were collected in medical practices and hospitals, drugstores, pharmacies and in scientific magazines. TV and radio programs were monitored, in the case of OTC drugs. 159 advertisements referring to pharmaceuticals were sent to ANVISA,from a total of 263 irregular ads analyzed between October 2004 and August 2005. The main problems found were the poor quality of drug information to health professionals, as well as misleading drug use to lay population. Based on the results of this project and on other studies, the banning of drug advertising in Brazil is proposed.

Psychoactive drug advertising: a comparison of technical information from three countries: Brazil, United States and United Kingdom.

CONTEXT AND OBJECTIVE: Studies carried out in the 1970s and 1980s showed that there were country-dependent disparities in the information given for the same drug in medical advertisements. National and international regulations have been published to do away with such disparities and to foster the rational use of drugs. The purpose of this study was to compare the information contained in psychoactive drug advertisements published in psychiatric journals in Brazil, the United States and the United Kingdom, before and subsequent to the publication of the United States Export Act, in 1986, the WHO criteria, in 1988, and the Brazilian Sanitary Surveillance Agency Resolution no. 102, in 2000. TYPE OF STUDY AND SETTING: Content analysis, at Centro Brasileiro de Informações sobre Drogas Psicotrópicas (Cebrid). METHODS: We gathered advertisements from Brazilian, American and British psychiatry periodicals published before and after each ruling. We analyzed a total of twenty-four Brazilian advertisements that were for the same psychoactive drugs as advertised in American and/or British publications from the same period. RESULTS: We observed that Brazilian advertisements omitted information on usage restrictions, such as contraindications, adverse reactions, interactions, warnings and precautions, and that such information was present in American and British advertisements. CONCLUSIONS: The data suggest that disparities in the information given for the same drug still persist. The information depends on the country in which each drug is marketed. The legislation is insufficient for eradicating such disparities.

[Amount and quality of food advertisement on Brazilian television]. / Quantidade e qualidade de produtos alimentícios anunciados na televisão brasileira.

The main objective of the study was to analyze the amount and quality of food advertisement on Brazilian television in three different times of the day. The results showed that food products, when compared to other products, were the most frequently advertised, regardless of the time of the day in a given week analyzed. Television promotes food predominantly high in fat and/or sugar and salt. The large number of high fat and/or sugar and salt products advertised can contribute to changing food habits of children and teenagers, and increasing the incidence of obesity in the population.

[Printed material distributed by pharmaceutical propaganda agents]. / Material informativo entregado por los agentes de propaganda médica.

Pharmaceutical sales representatives (drug reps) frequently visit 70% to 90% of physicians during their daily clinical practice and many consider the promotional printed material to be a major source of clinical information. We evaluated samples of the promotional printed material distributed to physicians by drug reps in order to determine whether the data contained in the promotional material is correct and supported by references accessible in Argentina. A consecutive sample of all the promotional material distributed by drug reps in the general internal medicine program (Hospital de Clínicas) was collected between March 15 and April 15, 2000. Reprints and monographs were excluded. Clinical information was reviewed by two general internists and compared to information in a major pharmacology textbook and in an electronic medical information program. References cited were reviewed for correct listing and accessibility in any of the four major medical libraries in Buenos Aires. Of the sixty-four pieces of promotional material collected, thirty were randomly selected and evaluated. In twenty one (70%) the therapeutic effect promoted in advertisement appeared in Goodman & Gilman's 9th edition textbook of pharmacology, in the pharmacology section of the Up-to-Date version 8.1 or in both. Only eighteen (60%) of the thirty promotional printed material evaluated had statements supported by cited references. From a total of 131 references cited in promotional materials, sixty (46%) were incorrectly listed according to the International Committee of Medical Journal Editors. These references were inaccessible. Of the 71 references correctly cited, 49 (69%) were not available in any of the four major medical libraries in Buenos Aires and 8 were available in only two of the libraries. Twenty-two references were reviewed, and in twelve of these (54%), the objective of the research study concurred with the statement of the promotional printed material. Adverse reactions, warnings about drug interactions and contraindications were absent from all promotional printed material. It can be concluded that the promotional printed material distributed by the drug reps in Buenos Aires are biased and provide misinformation more often than not. We recommend that practicing physicians routinely disregard promotional printed material as a source of clinical information.

Material informativo entregado por los agentes de propaganda medica / Printed material distributed by pharmaceutical propaganda agents

Se analizó el material impreso, de corta extensión y diseñado para atraer la atención sobre un producto que es entregado a los médicos en los consultorios con el objetivo de establecer si está basado en información cierta y accesible. Se recolectó todo el material, 64 ejemplares, que fue entregado en el Programa de Medicina Interna General del Hospital de Clínicas entre el 15/3 y el 15/4/00, se seleccionaron 30. Se analizó país de origen del laboratorio, la acción terapéutica propuesta, si ésta figuraba en dos fuentes de consulta utilizadas por los médicos y la existencia de referencias bibliográficas. Se averiguó si las citas bibliográficas se hallaban correctamente citadas y en estas se estableció su accesibilidad según se encontraran en las bibliotecas médicas más utilizadas de la ciudad de Buenos Aires. En los trabajos disponibles se examinó la concordancia entre el objetivo de la investigación y la información vertida en el material entregado. Se buscaron referencias a efectos adversos o precauciones a tener en cuenta en el momento de la prescripción. De los 30 ejemplares estudiados el 70 percent (21) correspondía a laboratorios extranjeros. La acción terapéutica propuesta en la propaganda coincidía con la bibliografía en 21 productos (70 por ciento). En ningún ejemplar se mencionaban los efectos adversos ni las precauciones. Dieciocho (60 percent) ejemplares poseían referencias bibliográficas, 131 en total. De éstas el 45.8 por ciento (60) estaban incorrectamente citadas y por lo tanto no pudieron ser solicitadas a las bibliotecas. De las 71 referencias correctas 49 (69 por ciento) fueron inaccesibles, 14 (19.7 por ciento ) accesibles y 8 (11.3) poco accesibles, en total solo 22 (16.7 percent) referencias pudieron ser analizadas. En 12 (54.5 por ciento) de las referencias analizadas, el objetivo del trabajo concordaba con la información vertida en el material entregado. El material provisto por los APMs no puede ser utilizado como fundamento para realizar una prescripción racional.