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.

Development Marketing Consumption Use Interrelations Regulation Knowledge Researchers Clinician Financial system Representation Communication Practice Pharmaceutical industry Media Distributor Government Representation Communication Practice Physicians Patients/Consumers Patient groups Pharmacists Families Representation Communication Practice

Development Marketing Consumption Use Interrelations Regulation Knowledge

Development Marketing Consumption Use Interrelation Regulation Knowledge Medications: anticancer drugs, antibiotics, antihypertensives General questions 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?  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.

Development Marketing Consumption Use Interrelations Regulation Knowledge Medications: anticancer drugs, analgesics, anti-inflammatories General questions 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)?  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.

Development Marketing Consumption Use Interrelations Regulation Knowledge Medications: anticancer drugs, hormone therapy, sildenafil (Viagra) General questions  What is the scope of the relationship systems (e.g., social-support networks), and what effect do these systems have on professional practices? 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? 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.

Development Marketing Consumption Use Interrelation Regulation Knowledge Medications: anticancer drugs, psychotropics, insulin General questions  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? 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? For example, recourse to medication for ADHD tends to increase the prescription of Ritalin and with it abuses such as addiction and racketeering.

Development Marketing Consumption Use Interrelation Regulation Knowledge Level 2 Model Building & Integration of Results

Biology Barthomeuf, Chantal Beaulac-Baillargeon, Louise Béliveau, Richard Legault, Jean Lussier, Marie-Thérèse Sidani, Souraya Lists of Researchers Sociology/Anthropology Cohen, David Dorval, Michel Lévy, Joseph-Josy Maisonneuve, Danielle Niquette, Manon Perron, Michel Pierret, Janine van der Geest, Sjaak Veillette, Suzanne 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 Advisory Committee Serge Moscovici Guy Rocher Reine Larose Harold Kalant

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 Students

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: Education Methods

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. 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. Conclusion