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Pharma Europe 2016 : Medical representative visits and opinion leaders: means of information and promotion for the pharmaceutical industry - Anne-Laure Pittet - University of Lausanne and Centre Hospitalier Universitaire Vaudois

Abstract

Medical representative visits (MRVs) are a means of information and a pharmaceutical strategy that is becoming less common, particularly visits involving generalists, all around Europe. In France, MRVs still remain a predominant pharmaceutical means of information about drugs for physicians, but increasingly the recommendations of drug regulatory authorities are to use representatives of health insurance and to participate in continuing medical education (CME). One of the results of our qualitative study in French-speaking Switzerland is that MRVs are deliberately very limited by generalists but still continue for specialists; participation in CME events is mandatory. Opinion leaders (OLs) are a means of information for physicians and a pharmaceutical strategy that is having an increasing impact. OLs interventions take place during CME events and conferences. The very concept of OLs needs to be clarified. A typology of OLs which was based on the international medical literature has been conducted, in order better to understand their roles and their increasing impacts as a means of information for physicians as well as a strategy for the pharmaceutical industry. An antimicrobial is a specialist that murders microorganisms or stops their growth. Antimicrobial medications can be assembled by the microorganisms they act fundamentally against. For instance, anti-infection agents are utilized against microorganisms, and antifungals are utilized against organisms. They can likewise be arranged by their capacity. Specialists that slaughter organisms are microbicidal, while those that only restrain their development are called biostatic. The utilization of antimicrobial meds to treat contamination is known as antimicrobial chemotherapy, while the utilization of antimicrobial medications to forestall disease is known as antimicrobial prophylaxis. The fundamental classes of antimicrobial specialists are disinfectants (non-particular operators, for example, blanch), which execute a wide scope of organisms on non-living surfaces to forestall the spread of ailment, germ-killers (which are applied to living tissue and help decrease disease during medical procedure), and anti-infection agents (which crush microorganisms inside the body). The expression "anti-infection" initially portrayed just those details got from living microorganisms however is currently additionally applied to engineered operators, for example, sulfonamides or fluoroquinolones. The term additionally used to be limited to antibacterials (and is frequently utilized as an equivalent for them by clinical experts and in clinical writing), however its setting has expanded to incorporate all antimicrobials. Antibacterial operators can be additionally partitioned into bactericidal specialists, which eliminate microorganisms, and bacteriostatic specialists, which delayed down or slow down bacterial development. Accordingly, further progressions in antimicrobial advancements have brought about arrangements that can go past essentially restraining microbial development. Rather, particular sorts of permeable media have been created to execute microorganisms on contact. Hypertension is a hazard factor for atherosclerosis, heart failure, coronary conduit disease, stroke, renal disease, and fringe blood vessel disease, and is the most significant hazard factor for cardiovascular bleakness and mortality, in industrialized countries. Prior to 1940 roughly 23% of all passings among people over age 50 were credited to hypertension. Extreme instances of hypertension were treated by surgery. Early advancements in the field of rewarding hypertension included quaternary ammonium particle thoughtful sensory system blocking specialists, yet these mixes were never generally utilized because of their extreme symptoms, on the grounds that the drawn out wellbeing results of hypertension had not yet been set up, and in light of the fact that they must be directed by infusion. In 1952 scientists at Ciba found the primary orally accessible vasodilator, hydralazine.[54] A significant deficiency of hydralazine monotherapy was that it lost its viability after some time (tachyphylaxis). In the mid-1950s Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co. found and created chlorothiazide, which remains the most broadly utilized antihypertensive medication today. This advancement was related with a considerable decrease in the death rate among individuals with hypertension. The designers were perceived by a Public Health Lasker Award in 1975 for "the sparing of untold a large number of lives and the easing of the enduring of a great many casualties of hypertension". A 2009 Cochrane survey inferred that thiazide antihypertensive medications decrease the danger of death (RR 0.89), stroke (RR 0.63), coronary illness (RR 0.84), and cardiovascular occasions (RR 0.70) in individuals with high blood pressure. In the guaranteeing years different classes of antihypertensive medication were created and discovered wide acknowledgment in blend treatment, including circle diuretics (Lasix/furosemide, Hoechst Pharmaceuticals, 1963), beta blockers (ICI Pharmaceuticals, 1964)ACE inhibitors, and angiotensin receptor blockers. ACE inhibitors decrease the danger of new beginning kidney infection [RR 0.71] and passing [RR 0.84] in diabetic patients, regardless of whether they have hypertension. Before the subsequent universal war, anti-conception medication was disallowed in numerous nations, and in the United States even the conversation of preventative strategies here and there prompted indictment under Comstock laws. The historical backdrop of the improvement of oral contraceptives is along these lines intently attached to the anti-conception medication development and the endeavors of activists Margaret Sanger, Mary Dennett, and Emma Goldman. The first detailing consolidated endlessly over the top dosages of hormones, and caused extreme symptoms. In any case, by 1962, 1.2 million American ladies were on the pill, and by 1965 the number had expanded to 6.5 million. The accessibility of a helpful type of impermanent prophylactic prompted emotional changes in social mores including extending the scope of way of life alternatives accessible to ladies, decreasing the dependence of ladies on men for preventative work on, empowering the deferral of marriage, and expanding pre-marriage co-home  Biography  Anne-Laure Pittet completed her PhD in Life Sciences from the University of Lausanne (Switzerland). She completed a Master of Advanced Studies (MAS) in Business Management at the University of Geneva (Switzerland). She is currently an Associate Researcher at the University Institute of the History of Medicine and Public Health (IUHMSP), Lausanne, Switzerland. Her main topic of interest is the interactions between the physicians, the pharmaceutical industry and the health authorities.   Anne-Laure.Pittet@unil.ch

 Anne-Laure Pittet and Friedrich Stiefel 

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