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The Medication Cycle. SSHRC Interdisciplinary Major Projects Team. Catherine Garnier. The Medication Cycle. Objectives.

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the medication cycle

The Medication Cycle

SSHRC Interdisciplinary Major Projects Team

Catherine Garnier

slide2

The Medication Cycle

Objectives

  • To analyze the dynamics of the medication cycle from development through consumption by studying the systems of representations, social practices and communications that operate within it .

2. To identify consensual, conflict and risk situations related to medications by exploring the fields of the circulation of knowledge, official and unofficial regulations, the interrelations of groups of social actors, and use.

  • To draw up and develop an interdisciplinary model of the medication cycle.
slide3

Pharmaceutical industry

Media

Distributor

Government

Researchers

Clinician

Financial system

Representation

Communication

Practice

Representation

Communication

Practice

Physicians

Patients/Consumers

Patient groups

Pharmacists

Families

Representation

Communication

Practice

Knowledge

Regulation

Marketing

Consumption

Development

Interrelations

Use

slide4

Knowledge

Regulation

Marketing

Consumption

Development

Interrelations

Use

slide5

How do the systems of social representations, practices and communication, as they relate to each other, make use of the different typesof knowledge circulating through the medication cycle?

Medications: anticancer drugs, antibiotics, antihypertensives

General questions

  • In the case of antibiotics, what effect does the diversity of knowledge have on issues of overprescription and overconsumption?

For example, in the case of antihypertensives, there is a disconnection between knowledge and experience of the disease, resulting in drugs being taken irregularly.

Knowledge

Regulation

Marketing

Consumption

Development

Interrelation

Use

slide6

What is the linkage between the explicit and implicit rules that apply to drugs as they relate to different points in the medication cycle and to groups of actors, their interests, and their place in the cycle in the three countries selected (France, Germany, Quebec)?

Medications: anticancer drugs, analgesics, anti-inflammatories

General questions

  • What is the relationship between economic and legislative factors in the marketing of new drugs, such as new anti-inflammatories that are more expensive but no more effective than the old ones?

For example, Vioxx and the chaotic situation between the various authorities responsible for the regulations and their application.

Knowledge

Regulation

Marketing

Consumption

Development

Interrelations

Use

slide7

How are social representations (menopause, impotence, death) linked to the communications practices established over the course of the interrelations between actors with regard to hormone therapy, Viagra and antiangiogenics?

  • What is the scope of the relationship systems (e.g., social-support networks), and what effect do these systems have on professional practices?

Medications: anticancer drugs, hormone therapy, sildenafil (Viagra)

General questions

For example, in the case of hormone therapy, following recent studies, there is a tendency to acknowledge the necessity for the various actors (women, physicians, the pharmaceutical industry) to become real partners.

Knowledge

Regulation

Marketing

Consumption

Development

Interrelations

Use

slide8

Given the controversies in North America and Europe over the use of Ritalin and the drug escalation that currently obtains, what are the representations of Ritalin among the stakeholders in France and Quebec?

  • How, following actor-based approaches, are systems of representations of the uses of drugs—more particularly antiangiogenics, psychotropics and insulin—transformed from one point to another of the cycle?

Medications: anticancer drugs, psychotropics, insulin

General questions

For example, recourse to medication for ADHD tends to increase the prescription of Ritalinand with it abuses such as addiction and racketeering.

Knowledge

Regulation

Marketing

Consumption

Development

Interrelation

Use

slide9

Model Building & Integration of Results

Level 2

Knowledge

Regulation

Marketing

Consumption

Development

Interrelation

Use

slide10

Sociology/Anthropology

Cohen, David

Dorval, Michel

Lévy, Joseph-Josy

Maisonneuve, Danielle

Niquette, Manon

Perron, Michel

Pierret, Janine

van der Geest, Sjaak

Veillette, Suzanne

Biology

Barthomeuf, Chantal

Beaulac-Baillargeon, Louise

Béliveau, Richard

Legault, Jean

Lussier, Marie-Thérèse

Sidani, Souraya

Advisory Committee

Serge Moscovici

Guy Rocher

Reine Larose

Harold Kalant

Lists of Researchers

Psychology

Bataille, Michel

Dufort, Francine

Doise, Willem

Jacquet-Mias, Christine

Piaser, Alain

Proulx, Robert

Scheibler-Meissner, Petra

Administrative Sciences

Crémieux, Pierre-Yves

Ebrahimi, Mehran

Merrigan, Philip

Saives, Anne-Laure

Turcotte, Marie-France

Philosophy/History/Ethics

Keel, Othmar

Robert, Serge A.

Somerville, Margaret A

slide11

Education

Students

  • 53 masters students;
  • 62 doctoral students;
  • (including Mathieu Gagné and Claude Giroux at Laval University, Luc Guerreschi, Chantal Ouellet, Claude Richard, Christine Thoër-Fabre)
  • 2 postdoctoral students.
slide12

Education

Methods

  • Integration into research projects;
  • Integration into educational programs;
    • Multimedia courses (Faculty of Social Studies, social and cultural representations)
    • Project to create a short interdisciplinary-research training program at the graduate level
    • Summer school: medications and research methods
  • Integration into scientific output;
    • Publications with student participation (15 articles and 3 books)
    • International Conference on Pharmaceutical Drugs: Fairmont Queen Elizabeth Hotel, August 29 to September 2, 2005 (information:www.geirso.uqam.ca)
features of the research program
Features of the research program
  • International
    • Three sites : Quebec (Quebec City, Montreal, Chicoutimi), France (Toulouse), Germany (Oldenburg).
  • Interdisciplinary:
    • 17 universities;
    • 19 different disciplines.
  • Holistic:
    • Current events highlight the critical need to consider the complexity of medications;
    • The different issues and interests in the scientific disciplines make attaining this objective difficult.

Conclusion

  • Despite this difficulty, the Major Projects on the Medication Cycle program seeks a break with the opposing viewpoints of the disciplines to foster instead the deeper development of the integrated model of the medication cycle.