U of T pain class bars drug-maker influence
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 was held into the complaint lodged earlier this year by a student and two doctors in the faculty of medicine.
The complaint centred on students being provided a book on managing chronic pain that was funded and copyrighted by the maker of the prescription painkiller OxyContin.
An unpaid guest lecturer with ties to the drug company brought the 371-page book into the university's Centre for the Study of Pain, which ran the pain class. The lecturer, who helped write the book, left copies for anyone who wanted them, according Dr. David Mock, the dean of dentistry.
Inquiry head Lorraine Ferris says she found no evidence of wrongdoing or actual conflict of interest.
But her report, obtained by The Canadian Press, says "time is of the essence" in revising the pain curriculum, a 20-hour course jointly taught to medical, dental, pharmacy and nursing students.
A revised program should include e delivery of balanced information by experts in several fields, including pharmacology and painkiller addiction, Ferris said in her report.
"As part of their discussions, faculty will need to address important, topical and often sensitive issues regarding opioids, including, for example, opioid addiction, improper opioid prescribing, at-risk communities, illicit sales and drug diversion, 'double-doctoring' and recreational sharing and use of opioids."
Dr. Rick Glazier, whose 18-year-old son died last year of an accidental overdose of the highly addictive OxyContin, and Dr. Philip Berger asked for the inquiry. They are both physicians at St. Michael's Hospital, one of the University of Toronto's teaching hospitals, and were approached by a medical student who was concerned about the industry-sponsored book brought to the pain centre.
'Likely will save lives'
Berger said he is pleased with Ferris's report, which "has met our concerns head-on."
"She's raised very serious issues of conflict of interest and made what I think is an absolutely correct statement that not only the academic community but the public more generally would find making a copyrighted and owned drug-company textbook available to students objectionable, regardless of how its assessed quality is," he said.
"To me, and I think quite correctly, she's called for a higher standard in a public policy area of a very high profile and of interest to both government and the public. I think it's fair to say that the implementation of Prof. Ferris's recommendations will make the public safer and likely will save lives."
In often bluntly worded statements, Ferris recommended that curriculum development and accountability for the pain course be transferred from the Centre for the Study of Pain, which conducts pain research and helps educate doctors, dentists, nurses and pharmacists.
The Centre for Interprofessional Education, which takes a multi-disciplinary approach to developing the skills of health professionals, will now take over curriculum and accountability. Ferris also recommended that only University of Toronto faculty members teach the pain course.
Mock said the four faculties involved in the interprofessional centre are implementing Ferris's recommendations.
"I think this is a good thing," Mock said. "I'm not looking at this as a hand-slap for the [pain] centre. I think what we've done is move it into the more modern governance system that we are developing at the university.
A study published last year showed prescription rates for opioids, including OxyContin, soared in Ontario over the last two decades, as did the number of deaths linked to the narcotic.