title: Pharmaceutical advertising in emergency departments.
abstract: OBJECTIVE
  Promotion of prescription drugs represents a growing source of pharmaceutical marketing expenditures. This study was undertaken to identify the frequency of items containing pharmaceutical advertising in clinical emergency departments (EDs).
  
  
  METHODS
  In this observational study, emergency physician on-site investigators quantified a variety of items containing pharmaceutical advertising present at specified representative times and days, in clinical EDs.
  
  
  RESULTS
  Measurements were obtained by 65 on-site investigators, representing 22 states. Most EDs in this study were community EDs (87% community and 14% university or university affiliate), and most were in urban settings (50% urban, 38% suburban, and 13% rural). Investigators measured 42 items per ED (mean = 42; median = 31; interquartile range of 14-55) containing pharmaceutical advertising in the clinical area. The most commonly observed items included pens (mean 15 per ED; median 10), product brochures (mean 5; median 3), stethoscope labels (mean 4; median 2), drug samples (mean 3; median 0), books (mean 3.4), mugs (mean 2.4), and published literature (mean 3.1). EDs with a policy restricting pharmaceutical representatives in the ED had significantly fewer items containing pharmaceutical advertising (median 7.5; 95% CI = 0 to 27) than EDs without such a policy (median 35; 95% CI = 27 to 47, p = 0.005, nonparametric Wilcoxon two-sample test). There were no differences in quantities of pharmaceutical advertising for EDs in community compared with university settings (p = 0.5), rural compared with urban settings (p = 0.3), or annual ED volumes (p = 0.9).
  
  
  CONCLUSIONS
  Numerous items containing pharmaceutical advertising are frequently observed in EDs. Policies restricting pharmaceutical representatives in the ED are associated with reduced pharmaceutical advertising.
authors.affiliation: Department of Emergency Medicine, St. Vincent Mercy Medical Center, 2213 Cherry Street, Toledo, OH 43608-2691, USA. cmarco2@aol.com
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Marco
mesh_terms: D000329:Advertising / Q000706:statistics & numerical data*; D004345:Drug Industry / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D016134:Organizational Policy; D011446:Prospective Studies; D014481:United States