Transcript LaChaineDesMedicaments

The Medication Cycle
SSHRC Interdisciplinary Major Projects Team
Catherine Garnier
The Medication Cycle
Objectives
1. 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.
3. To draw up and develop an interdisciplinary model of the medication
cycle.
Researchers
Clinician
Financial system
Representation
Communication
Practice
Pharmaceutical industry
Media
Distributor
Government
Representation
Communication
Practice
Representation
Communication
Practice
Physicians
Patients/Consumers
Patient groups
Pharmacists
Families
Knowledge
Regulation
Interrelations
Use
Development
Marketing
Consumption
Knowledge
Regulation
Interrelations
Use
Development
Marketing
Consumption
How do the systems of social representations, practices and communication, as
they relate to each other, make use of the different types of 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
Interrelation
Use
Development
Marketing
Consumption
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
Interrelations
Use
Development
Marketing
Consumption
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
Interrelations
Use
Development
Marketing
Consumption
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
Ritalin and with it abuses such as addiction and racketeering.
Knowledge
Regulation
Interrelation
Use
Development
Marketing
Consumption
Model Building & Integration of Results
Level 2
Knowledge
Regulation
Interrelation
Use
Development
Marketing
Consumption
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
Sociology/Anthropology
Cohen, David
Dorval, Michel
Lévy, Joseph-Josy
Maisonneuve, Danielle
Niquette, Manon
Perron, Michel
Pierret, Janine
van der Geest, Sjaak
Veillette, Suzanne
Lists of Researchers
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
Psychology
Bataille, Michel
Dufort, Francine
Doise, Willem
Jacquet-Mias, Christine
Piaser, Alain
Proulx, Robert
Scheibler-Meissner, Petra
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.
Education
Methods
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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
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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.