INTRODUCTION: The information provided by pharmaceutical sales representatives has been shown to influence prescribing. To enable safe prescribing, medicines information must include harm as well as benefits. Regulation supports this aim, but relative effectiveness of different approaches is Nike Roshe Run not known. The United States (US) and France directly regulate drug promotion; Canada relies on industry self-regulation. France has the strictest information standards.METHODS: This is a prospective cohort study in Montreal, Vancouver, Sacramento and Toulouse. We recruited random samples of primary care physicians from May 2009 to June 2010 to report on consecutive sales visits. nike Roshe Run Malaysia The primary outcome measure was \"minimally adequate safety information\" (mention of at least one indication, serious adverse event, common adverse event, and contraindication, and no unqualified safety claims or unapproved indications).RESULTS: Two hundred and fifty-five physicians reported on 1,692 drug-specific promotions. \"Minimally adequate safety information\" did not differ: 1.7 % of promotions; range 0.9-3.0 % per site. Sales representatives provided some vs. no information on harm more often in Toulouse than in Montreal and Vancouver: 61 % vs. 34 %, OR = 4.0; 95 % CI 2.8-5.6, or Sacramento (39 %), OR = 2.4; 95 % CI 1.7-3.6. Serious adverse events were rarely mentioned (5-6 % of promotions in all four sites), although 45 % of promotions were for drugs with US Food and Drug Administration (FDA) \"black box\" warnings of serious risks. Nevertheless, physicians judged the quality of scientific information to be good or excellent in 901 (54 nike Roshe Run Online %) of promotions, and indicated readiness to prescribe 64 % of the time.DISCUSSION: \"Minimally adequate safety information\" did not differ in the US and Canadian sites, despite regulatory differences. In Toulouse, consistent with nike Roshe Run Singapore stricter standards, more harm information was provided. However, in all sites, physicians were rarely informed about serious adverse events, raising questions about whether current approaches to regulation of sales representatives adequately protect patient health.Comment inPharmaceutical sales representatives and patient safety. [J Gen Intern Med. 2013]Pharmaceutical sales representatives and patient safety.Light DW. J Gen Intern Med. 2013 Nov; 28(11):1394. Pharmaceutical sales representatives and patient safety. [J Gen Intern Med. 2013]Pharmaceutical sales representatives and patient safety.Mintzes B, Lexchin J, Wilkes MS, Beaulieu MD, Reynolds E, Sutherland J, Durrieu G. J Gen Intern Med. 2013 Nov; 28(11):1395.