To ensure that annual meeting sessions continue to focus on science rather than on the products of particular drug companies, APA has enhanced the process by which it monitors symposia that are supported by the pharmaceutical industry.

APA now assigns a resident psychiatrist to monitor every industry-supported symposium (the resident receives a small honorarium from APA for this work), asks session attendees to rate each presenter as well as the overall session, and distributes and collects evaluation forms itself instead of leaving that task to the drug company supporting the symposium. APA also audiotapes all industry-supported sessions in case attendees register complaints about product promotions during a symposium.

The resident monitors are each given a form on which they indicate, for example, if commercial information is visible during a symposium, whether presenters referred to drugs by brand or generic names, if one product was clearly promoted over others, whether audience members were allowed to ask critical questions, and whether speakers disclosed significant financial relationships with supporting companies and if they were discussing an off-label, that is, non-FDA-approved, use of a drug.

The stepped-up monitoring process began at the October 1997 Institute on Psychiatric Services, where, as with the May annual meeting, industry-supported symposia are an integral and popular part of the scientific program. APA developed its new procedures to ensure compliance with the Standards for Commercial Support of the Accreditation Council for Continuing Medical Education (ACCME). Among these guidelines are limits on the activities of pharmaceutical representatives during a symposium and limits on the number of pharmaceutical industry employees making presentations.

The new procedures are based on recommendations made by an ad hoc committee appointed after the 1997 annual meeting to review industry-supported CME activities. The committee was appointed as a response to complaints about unnecessary promotions by the pharmaceutical companies. The ad hoc committee’s recommendations included limits on the activities of pharmaceutical employees during the presentations.

The committee suggested that all presenters should also have to reveal any potential conflicts of interest stemming from their relationship with the supporting company.

The committee also urged APA to establish a database that would store evaluations of presenters and symposia, so that the subcommittee that selects each meeting’s industry-supported symposia would be able to assess whether a low-evaluated presenter is the best choice for future programs.

APA has implemented all of the ad hoc committee’s recommendations.

"The enhanced oversight ensures the scientific integrity of industry-supported symposia and demonstrates APA control over the content of the sessions and the qualifications of presenters on the panel," explained Kathleen Debenham, director of APA’s Office of Continuing Medical Education. "Those are critical elements of compliance with the ACCME Standards for Commercial Support." She noted as well that APA will soon hire a full-time staff member to oversee and develop further procedures for commercially supported educational activities.

Stephen Goldfinger, M.D., chair of the APA Committee on Commercial Support, told Psychiatric News that APA’s efforts to improve the scrutiny of industry-supported symposia has "involved a tremendous amount of work from a wide array of APA members and staff."

He pointed out that in February, as part of the enhanced review procedures, he and two other reviewers were listening to the tapes of sessions at last year’s annual meeting about which complaints were registered concerning objectivity or product promotion. If there is a consensus that presenters violated APA’s guidelines, they will be asked to describe the ways in which they will correct the problems before they present at another annual meeting symposium. Participation in this year’s or future industry-supported symposium depends on the presenters providing satisfactory improvement plans, Goldfinger noted.