‘You feel like you’ve been duped’: is the current system for health professionals declaring potential conflicts of interest in the UK fit for purpose? A mixed methods study

• Published in: BMJ open 2023-07, Vol.13 (7), p.e072996-e072996
• Main Authors: McCartney, Margaret, Metsis, Katrin, MacDonald, Ronald, Sullivan, Frank, Ozakinci, Gozde, Boylan, Anne-Marie
• Format: Article
• Language: English
• Subjects: Conflict of Interest; Conflicts of interest; Emotions; Funding; Health Personnel; Health policy; Health services; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; Health Services Research; Humans; Information management; Medical equipment; MEDICAL ETHICS; Medical personnel; Mixed methods research; Narcotics; Patient-Centered Care; Patients; Pharmaceutical industry; Physicians; Professionals; Protocols & guidelines; Questionnaires; Scholarly publishing; Trust; United Kingdom
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-072996

ObjectiveTo understand: if professionals, citizens and patients can locate UK healthcare professionals’ statements of declarations of interests, and what citizens understand by these.DesignThe study sample included two groups of participants in three phases. First, healthcare professionals working in the public domain (health professional participants, HPP) were invited to participate. Their conflicts and declarations of interest were searched for in publicly available data, which the HPP checked and confirmed as the ‘gold standard’. In the second phase, laypeople, other healthcare professionals and healthcare students were invited to complete three online tasks. The first task was a questionnaire about their own demographics. The second task was questions about doctors’ conflicts of interest in clinical vignette scenarios. The third task was a request for each participant to locate and describe the declarations of interest of one of the named healthcare professionals identified in the first phase, randomly assigned. At the end of this task, all lay participants were asked to indicate willingness to be interviewed at a later date. In the third phase, each lay respondent who was willing to be contacted was invited to a qualitative interview to obtain their views on the conflicts and declaration of interest they found and their meaning.SettingOnline, based in the UK.Participants13 public-facing health professionals, 379 participants (healthcare professionals, students and laypeople), 21 lay interviewees.Outcome measures(1) Participants’ level of trust in professionals with variable conflicts of interest, as expressed in vignettes, (2) participants’ ability to locate the declarations of interest of a given well-known healthcare professional and (3) laypeoples’ understanding of healthcare professionals declarations and conflicts of interest.ResultsIn the first phase, 13 health professionals (HPP) participated and agreed on a ‘gold standard’ of their declarations. In the second phase, 379 citizens, patients, other healthcare professionals and students participated. Not all completed all aspects of the research. 85% of participants thought that knowing about professional declarations was definitely or probably important, but 76.8% were not confident they had found all relevant information after searching. As conflicts of interest increased in the vignettes, participants trusted doctors less. Least trust was associated with doctors who had not disclosed their con