Constructing a problem and marketing solutions: A critical content analysis of the nature and function of industry-authored oral health educational materials.

2020 
AIMS AND OBJECTIVES To document the nature of industry-authored educational materials focused on oral health; and analyse how they construct the relationships between nurses and industry. BACKGROUND Nurses frequently rely on pharmaceutical and medical device companies for continuing education. However, industry-sponsored education is a key aspect of multi-faceted promotional campaigns and may introduce bias into clinical decision-making. DESIGN Critical qualitative content analysis reported according to the COREQ checklist. METHODS We purposively sampled educational documents from the websites of 4 major manufacturers of oral health products for acute care. Two researchers analyzed each document using an open-ended coding form. We conducted an interpretive analysis using inductive coding methods. RESULTS We included 63 documents that emphasized the importance of education in the form of training, expert guidance, evidence syntheses, and protocols to support oral care practices. Industry promoted its relationship with nursing as an oral health authority through three dominant messages: 1) Pneumonia is a source of morbidity, mortality and treatment costs, which informed nurses about a critical problem; 2) Comprehensive oral care reduces pneumonia risk, which instructed nurses about product-oriented solutions; and 3) Frequent oral care is important, which emphasized compliance to standardized protocols. These messages formed an accountability logic that prompted clinicians to address a problem for which the company's products served as a solution. In doing so, industry validated dominant administrative concerns including compliance, while promoting product uptake. CONCLUSIONS Industry-authored educational materials may promote industry interests, rather than nursing or patient agendas. Dependence on industry's information and product solutions may have unintended, negative consequences for nursing practice. RELEVANCE TO CLINICAL PRACTICE Though industry's educational materials present as convenient, helpful, and evidence-based, they may serve to redirect care processes in ways that reinforce company goals rather than clinical priorities. Nurses should seek independent sources of continuing education where possible.
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