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Gillani AH, Arshad H, Umer MF, Arshed M, Khan FU, Bashir K, Xu S, Mujtaba H, Mohamed Ibrahim MI, Fang Y. Effect of pharmaceutical promotion and incentives offered by pharmaceutical companies on the prescribing pattern of medical students: a cross-sectional study from a developing nation Pakistan. Front Med (Lausanne) 2024; 11:1334518. [PMID: 38846143 PMCID: PMC11153857 DOI: 10.3389/fmed.2024.1334518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Background Pharmaceutical companies continuously pursue healthcare professionals, starting from the medical college level, which can ultimately lead to irrational prescribing of drugs and antibiotics. Therefore, our main aim was to evaluate the opinions and attitudes of medical students toward pharmaceutical promotion. Methods This study utilized a cross-sectional online survey that applied the snowball sampling technique. Data were collected from three public and three private sector medical colleges in Punjab, Pakistan using snowball sampling. A modified version of a pre-structured questionnaire was used to collect data between October 2020 and January 2021. Medical students from the third year onward were captivated. The tool was made available on Google Forms and students could access it by clicking the link shared. The effect of promotion on prescribing pattern and future prescribing of antibiotics were measured. Descriptive statistics, chi-square, and t-test were used to analyze the data. Results A total of 1,301 students filled out the survey, but only 1,227 responses were acceptable. The average age was found to be 23.4 ± 1.59 years. Slightly more than half of the respondents were male participants (57.7%), and a significant proportion (84.1%) reported being aware of pharmaceutical promotion. A smaller number (27.7%) felt that physicians who meet medical representatives more frequently tend to prescribe more antibiotics and 46.3% indicated they would be willing to prescribe antibiotics under the promotional influence. Medical students who were male, in senior college years, attended government institutions, and had lower parental income showed significantly higher perception and attitude scores (p < 0.05) which, in turn, may show their inclination to promotional activities. Many students agreed with the view that pharmaceutical promotion (PP) activities may alter prescribing practices and also believed that they contribute to the increased irrational prescribing of drugs and antibiotics. Conclusion The study revealed that only a small number of students are willing to engage in promotional activities and accept rewards, which influences their choice toward selection of drugs and antibiotics. This study highlighted the necessity of giving proper educational instructions regarding the promotion of drugs to medical students. This study also focused on the educational prerequisites of the students.
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Affiliation(s)
- Ali Hassan Gillani
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Hafsa Arshad
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Muhammad Farooq Umer
- Departement of Preventive Dentistry, College of Dentistry, King Faisal University, Hofuf, Alahsa, Saudi Arabia
| | - Muhammad Arshed
- University Institute of Public Health, Faculty of Allied Health Sciences, The University of Lahore, Punjab, Pakistan
| | - Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Kamran Bashir
- College of Pharmacy, University of Sargodha, Sargodha, Pakistan
| | - Sen Xu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
| | - Hasan Mujtaba
- Department of Pathology Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan
| | | | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi’an, Shaanxi, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an, China
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Gameiro GR, Gameiro GR, Silva RME, Guilloux AGA, Cassenote AJF, Scheffer MC. Physician's perceptions regarding the pharmaceutical industry: a Brazilian national study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231317. [PMID: 38775504 PMCID: PMC11111120 DOI: 10.1590/1806-9282.20231317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/19/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking. METHODS A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents. RESULTS Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions. CONCLUSION The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.
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Affiliation(s)
| | - Gustavo Rosa Gameiro
- Clínica de Olhos Norte do Paraná – Londrina (PR), Brazil
- Universidade de São Paulo, Faculty of Medicine, Medical Education Development Center – São Paulo (SP), Brazil
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Ophthalmology and Visual Sciences – São Paulo (SP), Brazil
| | - Renan Magalhães e Silva
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
| | - Aline Gil Alves Guilloux
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
| | | | - Mario César Scheffer
- Universidade de São Paulo, Faculty of Medicine, Department of Preventive Medicine – São Paulo (SP), Brazil
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Noor MN, Khan M, Rahman-Shepherd A, Siddiqui AR, Khan SS, Azam I, Shakoor S, Hasan R. Impact of a multifaceted intervention on physicians' knowledge, attitudes and practices in relation to pharmaceutical incentivisation: protocol for a randomised control trial. BMJ Open 2022; 12:e067233. [PMID: 36332959 PMCID: PMC9639112 DOI: 10.1136/bmjopen-2022-067233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION In settings where the private sector constitutes a larger part of the health system, profit-gathering can take primacy over patients' well-being. In their interactions with pharmaceutical companies, private general practitioners (GPs) can experience the conflict of interest (COI), a situation whereby the impartiality of GPs' professional decision making may be influenced by secondary interests such as financial gains from prescribing specific pharmaceutical brands. METHODS AND ANALYSIS This study is a randomised controlled trial to assess the impact of a multifaceted intervention on GPs' medical practice. The study sample consists of 419 registered GPs who own/work in private clinics and will be randomly assigned to intervention and control groups. The intervention group GPs will be exposed to emotive and educational seminars on medical ethics, whereas control group GPs will be given seminars on general medical topics. The primary outcome measure will be GPs' prescribing practices, whereas the secondary outcome measures will be their knowledge and attitudes regarding COI that arises from pharmaceutical incentivisation. In addition to a novel standardised pharmaceutical representatives (SPSR) method, in which field researchers will simulate pharmaceutical marketing with GPs, presurvey and postsurvey, and qualitative interviewing will be performed to collect data on GPs' knowledge, attitudes and practices in relation to COI linked with pharmaceutical incentives. Univariate and multivariate statistical analyses will be performed to measure a change in GPs' knowledge, attitudes and practices, while qualitative analysis will add to our understanding of the quantitative SPSR data. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Pakistan National Bioethics Committee (# 4-87/NBC-582/21/1364), the Aga Khan University (# 2020-4759-1129) and the London School of Hygiene and Tropical Medicine (# 26506). We will release results within 6-9 months of the study's completion. TRIAL REGISTRATION NUMBER ISRCTN12294839.
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Affiliation(s)
- Muhammad Naveed Noor
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Mishal Khan
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Afifah Rahman-Shepherd
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Sabeen Sharif Khan
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Iqbal Azam
- Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Sadia Shakoor
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Rumina Hasan
- Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Sindh, Pakistan
- Faculty of Infectious and Tropical Disease, The London School of Hygiene and Tropical Medicine, London, UK
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Faqeh S, Alansari S, Althagafi A, Abdulaziz A, Alhajjaji A, Kurdi A, Allihyani M, Qashlan M, Alhotirshi R, Alhassani R, Alsurayhi S, Alshareef O, Ali M. Views and Perceptions of Medical Representatives and Physicians about the Role of Medical Representatives and Pharmaceutical Advertisement in Saudi Arabia - A Pilot Study. J Res Pharm Pract 2022; 11:127-135. [PMID: 37969614 PMCID: PMC10642585 DOI: 10.4103/jrpp.jrpp_65_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/16/2022] [Indexed: 11/17/2023] Open
Abstract
Objective Medical representatives (MRs) frequently interact with physicians who may have different perceptions about and expectations from product promotional activities by pharmaceutical companies, especially through MRs. This can affect their prescribing practice. We explored the views and perceptions of MRs and physicians about the role of MRs and pharmaceutical advertisements in Saudi Arabia. Methods Semi-structured interviews were conducted virtually through the ZOOM application with five MRs and five physicians from July to October 2022. The participants were recruited from the Makkah region in Saudi Arabia on a convenience sampling basis and through the snowballing method. The interviews were recorded with the consent of the participants, transcribed verbatim, and thematically analyzed. Findings Data saturation was found to be achieved with four interviews from each group of participants. Thematic analysis generated 338 codes which were categorized into 31 subthemes. These subthemes were further categorized into 11 overarching themes: "MR daily work," "Role of MRs in healthcare and their future," "Value of MRs in healthcare," "Pros and cons of the MR career," "MRs in the COVID-19 pandemic," "Differences between the pharmaceutical companies," "Goods and not-so-goods about the MRs," "Suggestions provided by physicians for MRs and pharmaceutical companies," "Marketing strategies of different pharmaceutical companies," "Experience of MRs" and "Support provided by pharmaceutical companies." Conclusion Our pilot study sheds light on the role of MRs and pharmaceutical advertisement from MRs' and physicians perspectives. Several recommendations can be drawn from our findings to make the interactions between MRs and physicians more effective and improve pharmaceutical advertisement, prescribing practices, and patient care.
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Affiliation(s)
- Sultan Faqeh
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Safwan Alansari
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulrahman Althagafi
- Department of Pharmaceutical Care, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Akrm Abdulaziz
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulrahman Alhajjaji
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmad Kurdi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Moayad Allihyani
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mutaz Qashlan
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Raghad Alhotirshi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rawan Alhassani
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, California, United States
| | - Suhail Alsurayhi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Omar Alshareef
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Majid Ali
- Department of Basic Sciences, College of Medicine, Sulaiman Al-Rajhi University, Al-Bukayriyah, Saudi Arabia
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Al-Areefi MA, Ibrahim MIM, Hassali MAA, Alfadl AA. Influences on interactions between physicians in the public and private sectors and medical representatives in Yemen. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2020. [DOI: 10.1111/jphs.12375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Objective
This study aims to assess the relative importance of attitude and subjective norms as well as physicians' characteristics and practice-setting factors in predicting the outcome of physicians' interactions with MRs.
Methods
A cross-sectional survey was conducted among a convenience sample of 602 physicians in Sana'a, Yemen. The data were analysed using descriptive and inferential analyses. The t-test/Mann–Whitney test and ANOVA/Kruskal–Wallis test with post hoc analysis, principal component analysis, correlation analysis and regression analysis were applied at an a priori significance level of 0.05.
Key findings
The response rate was 76.5%. Results showed that physicians who see a greater number of MRs per week or have academic affiliations were significantly more likely to have received high/low-value promotional items than were those who saw fewer MRs or have no academic affiliations (P values < 0.001 and 0.021, respectively). Also male physicians and physicians who have private clinics were significantly more likely to have received high-value promotional items (P value < 0.001). Three out of five hypotheses were supported (physicians' belief in the appropriateness of accepting high/low-value pharmaceutical companies' promotional techniques relate positively and significantly to their behaviour of interactions with MRs, and physicians' attitudes towards pharmaceutical companies relates positively and significantly to their interactions with MRs).
Conclusion
Physicians in Yemen consider most of the promotional techniques as normal practice. The article provides empirical evidence for policymakers in developing countries in general, and Yemen specifically, to develop suitable policies and regulations for drug promotion.
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Affiliation(s)
- Mahmoud A Al-Areefi
- Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | - Abubakr A Alfadl
- Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
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Salmane-Kulikovska I, Poplavska E, Mezinska S, Dumpe V, Dauvarte H, Lazdina L, Marchockij A, Varzinskas K, Mintzes BJ. Medical, pharmacy and nursing students in the Baltic countries: interactions with the pharmaceutical and medical device industries. BMC MEDICAL EDUCATION 2020; 20:105. [PMID: 32252743 PMCID: PMC7137495 DOI: 10.1186/s12909-020-02008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Interactions between pharmaceutical and medical device industries and students can lead to commercial influences on educational messages, with a potential to bias future treatment choice. This is the first study in the Baltic countries describing exposure and attitudes of medical, pharmacy and nursing students towards cooperation with industry. METHODS A cross-sectional on-line survey of current medical, pharmacy and nursing students (n = 918) in three Baltic countries was carried out. RESULTS We found that most students participate in events organized or sponsored by industry and accept a range of gifts and benefits. Students in the Baltic countries consider cooperation with industry important; at the same time, most do not feel that they have sufficient training on how to ethically interact with pharmaceutical and medical device companies and believe that these interactions can influence their prescribing or dispensing patterns. There is a tendency to rationalize cooperation with industry by referring to the current economic situation and patient benefits. Pharmacy students have higher rates of participation and they accept gifts and other benefits more often than nursing or medical students; therefore, they are likely to be more vulnerable to potential industry influence. CONCLUSIONS The findings highlight the need to include topics on ethics and conflicts of interests in cooperation with industry in curriculum of health care students in Baltic countries. Without proper training, students continue to be at risk to industry influence and may develop habits for their further practice differing from evidence-based practice in prescribing and dispensing of medicines, as well as use of medical devices.
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Affiliation(s)
| | - Elita Poplavska
- Faculty of Pharmacy and Institute of Public Health, Riga Stradins University, Dzirciema street 16, Riga, LV 1007 Latvia
| | - Signe Mezinska
- Faculty of Medicine and Institute of Clinical and Preventive medicine, University of Latvia, Raina blvd. 19, Riga, LV-1050 Latvia
| | - Vita Dumpe
- Health Projects for Latvia, Baznicas street 5 - 2, Riga, LV 1010 Latvia
| | - Helena Dauvarte
- Riga Stradins University, Dzirciema street 16, Riga, LV 1007 Latvia
| | - Lina Lazdina
- Pauls Stradins Clinical University Hospital, Pilsoņu street 13, Riga, LV-1002 Latvia
| | - Aleksandr Marchockij
- Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, Kaunas, Lithuania
| | - Karolis Varzinskas
- Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, Kaunas, Lithuania
| | - Barbara J. Mintzes
- Faculty of Pharmacy and Charles Perkins Centre, The University of Sydney, Room 6W75, 6th Floor, The Hub, Charles Perkins Centre D17, Sydney, NSW 2006 Australia
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Albaker AM, Alosaimi FD. Knowledge and attitude towards dentist-industry relationship and their association with own behavior among dentists working in Saudi Arabia. Saudi Pharm J 2019; 27:155-161. [PMID: 30766424 PMCID: PMC6362275 DOI: 10.1016/j.jsps.2018.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 09/17/2018] [Indexed: 10/28/2022] Open
Abstract
Objectives To examine the knowledge and attitude towards dentist-industry relationship including accepting gifts, influence on decisions, and accuracy of given information among dentists working in Saudi Arabia. In addition, to examine the association of such knowledge and attitude of dentists' behavior with industry, including sorts of interaction and accepting industrial gifts. Methods A cross-sectional study was conducted among dental practitioners working in the private and governmental hospitals located in the various regions of Saudi Arabia. A self-administrated questionnaire was developed and distributed to all participants. Fourteen questions assessed the socio-demographic, economic, and occupational characteristics of the participants including age, gender, nationality, monthly revenue, income satisfaction, hospital setting, job rank, specialty, and patients' socio- economic status. Seventeen questions assessed the interaction with DSRs, acceptance and characteristics of gifts and opinion of dentists regarding gift acceptance in dental practice. One-Way ANOVA and t-test was used to examine differences in transformed scores by socio-demographic, occupations and outcome characteristics. All P-values were two-tailed. P-value < 0.05 was considered as significant. Results Total of 672 participants responded to general questions related to the knowledge and attitude. The mean of the overall knowledge and attitude score was 64.3 ± 7.2, general questions score was 63.1 ± 8.6 and interaction questions score was 66.9 ± 8.0. Approximately, 40% of participants disagreed that accepting industrial gifts can affect their own decisions but slightly lower proportion (25%) disagreed that accepting industrial gifts can affect decisions of other dentists. Only 25% of participants thought it is ethical to accept industrial gifts and even fewer proportions (20%) believed that dental supply representatives (DSRs) always provide accurate information about their new materials. Almost two-thirds of participants trusted information from other sources than from DSRs. On the other hand, 40% of the participants were against banning industrial gifts to dentists and approximately 50% were against informing the patients about the industrial gifts given to their dentist by dental companies. Conclusions There was insufficient knowledge and an overall positive attitude towards the dental industry among the sample of dentists in Saudi Arabia. Well-designed ethical education programs should be implemented to enhance knowledge and attitudes about the interactions with dental industry.
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Affiliation(s)
- Abdulaziz M Albaker
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahad D Alosaimi
- Department of Psychiatry, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Saudi Arabia
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Antecedents of Symmetry in Physicians’ Prescription Behavior: Evidence from SEM-based Multivariate Approach. Symmetry (Basel) 2018. [DOI: 10.3390/sym10120721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to examine the direct impact of marketing and medical tools on the symmetry of physicians’ prescription behavior in the context of the Pakistani healthcare sector. This research also investigates the moderating influence of corporate image and customer relationship in an association of marketing & medical tools, and the symmetry of physicians’ prescription behavior. The survey involved a research sample of 740 physicians, comprising 410 general practitioners and 330 specialists. A series of multivariate approaches such as exploratory factor analysis, confirmatory factor analyses, and conditional process analysis are employed. The findings of the study showed that marketing & medical tools have a direct, positive, and significant influence on physicians’ symmetrical prescription behavior. Corporate image and customer relationship have also a significant impact as moderating variables between marketing & medical tools, and the symmetry of prescription behavior of physicians. The outcomes of this research are beneficial to marketers and medical managers in the pharmaceutical industry.
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Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians' attitudes and prescribing habits: a systematic review. BMJ Open 2017; 7:e016408. [PMID: 28963287 PMCID: PMC5623540 DOI: 10.1136/bmjopen-2017-016408] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The objective of this review is to explore interactions between physicians and the pharmaceutical industry including sales representatives and their impact on physicians' attitude and prescribing habits. DATA SOURCES PubMed, Embase, Cochrane Library and Google scholar electronic databases were searched from 1992 to August 2016 using free-text words and medical subject headings relevant to the topic. STUDY SELECTION Studies included cross-sectional studies, cohort studies, randomised trials and survey designs. Studies with narrative reviews, case reports, opinion polls and letters to the editor were excluded from data synthesis. DATA EXTRACTION Two reviewers independently extracted the data. Data on study design, study year, country, participant characteristics, setting and number of participants were collected. DATA SYNTHESIS Pharmaceutical industry and pharmaceutical sales representative (PSR) interactions influence physicians' attitudes and their prescribing behaviour and increase the number of formulary addition requests for the company's drug. CONCLUSION Physician-pharmaceutical industry and its sales representative's interactions and acceptance of gifts from the company's PSRs have been found to affect physicians' prescribing behaviour and are likely to contribute to irrational prescribing of the company's drug. Therefore, intervention in the form of policy implementation and education about the implications of these interactions is needed.
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Affiliation(s)
| | | | - Ewout Urbach
- Crowd for Cure, Groningen, Groningen, The Netherlands
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No aplica NA. Artículo retirado de la tabla de contenidos por duplicidad. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n3.59214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Artículo retirado de la tabla de contenidos por duplicidad
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Filippiadou M, Kouvelas D, Garyfallos G, Tsakiridis I, Tzachanis D, Spachos D, Papazisis G. Exposure to the drug company marketing in Greece: Interactions and attitudes in a non-regulated environment for medical students. Ann Med Surg (Lond) 2017; 19:23-28. [PMID: 28603612 PMCID: PMC5454084 DOI: 10.1016/j.amsu.2017.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Medical students are targeted by the pharmaceutical industry and are exposed to their marketing strategies even in the preclinical years of study. The marketing strategies used by pharmaceutical companies with physicians are also applied to students, affecting their future prescribing behaviour, and include low-cost non-educational gifts, travel expenses and conferences registration fees. In Greece, there are no national or institutional regulations and guidelines concerning drug company-medical student interactions. This study is the first time this estimate has been made in Greece and assessed a) the interactions between pharmaceutical companies and medical students, and b) students' attitudes towards pharmaceutical marketing. METHODS A sampling of undergraduate medical students completed an anonymous, self-administered, web-based survey. The first part of the survey investigated the interaction between the students and pharmaceutical companies; the possible answers were the binomial variables 'yes' or 'no'. The second part assessed the students' opinions of pharmaceutical company marketing and the answer options were 'agree', 'don't know/don't answer' and 'disagree'. RESULTS The survey was completed by 412 undergraduate medical students (mean age 22 ± 2.2 years, 52.7% were women); the overall response rate was 58.9%. Although the majority did not consider accepting gifts and meals from drug companies as ethical, most of them (59%) had accepted meals and low-cost non-educational gifts, especially the clinical-level students. Further, 52,6% of the students did not believe that accepting gifts from pharmaceutical companies would affect their own prescription behaviour, whereas surprisingly they held the opposite opinion of their classmates. The vast majority (85.9%) agreed that sponsored lectures were biased in favour of a company's products; however, 47.6% agreed that promotional material is useful for learning about new medications and 34.5% believed that medical schools should allow drug company representatives to interact with students. CONCLUSION Our results suggest that medical students in Greece are notably exposed to pharmaceutical industry marketing and their conflicting answers demonstrate that they are inadequately prepared for this interaction. Interventions are needed so that students are prepared and able to manage these interactions critically.
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Affiliation(s)
- Magdalini Filippiadou
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
- 2nd University Department of Psychiatry, Psychiatric Hospital of Thessaloniki, Greece
| | - Dimitrios Kouvelas
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Garyfallos
- 2nd University Department of Psychiatry, Psychiatric Hospital of Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Tzachanis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Dimitrios Spachos
- Department of Medical Physics, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
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Beyhun NE, Kolayli CC, Can G, Topbas M. Turkish Final Year Medical Students' Exposure to and Attitudes Concerning Drug Company Interactions: A Perspective from a Minimally Regulated Environment for Medical Students. PLoS One 2016; 11:e0168094. [PMID: 27977744 PMCID: PMC5158011 DOI: 10.1371/journal.pone.0168094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 11/24/2016] [Indexed: 11/18/2022] Open
Abstract
Interactions between drug companies and medical students may affect evidence-based medical practice and patient safety. The aim of this study was to assess drug company-medical student interactions in a medical faculty where limited specific national or institutional regulations apply between drug companies and medical students. The objectives of the study were to determine the exposure and attitudes of final year medical students in terms of drug company-medical student and physician interactions, to identify factors affecting those attitudes and to provide data for policymakers working on the regulation of interactions between drug companies and medical students. This anonymous questionnaire-based study of 154 medical final year medical students at the Karadeniz Technical University Medical Faculty, Trabzon, Turkey, in April and May 2015 attracted a response rate of 92.2% (n/N, 154/164). Exposure to interaction with a pharmaceutical representative was reported by 90.3% (139/154) of students, and 68.8% (106/154) reported experiencing such interaction alongside a resident. In addition, 83.7% (128/153) of students reported an interaction during internship. Furthermore, 69.9% (107/153) of students agreed that interactions influence physicians' prescription preferences, while 33.1% (51/154) thought that a medical student should never accept a gift from a drug company and 24.7% (38/154) agreed with the proposition that "drug companies should not hold activities in medical faculties". Students with rational prescription training expressed greater agreement with the statement "I am skeptical concerning the information provided by drug companies during interactions" than those who had not received such training, and this finding was supported by logistic regression [O.R.(C.I), p -3.7(1.2-11.5), p = 0.022]. Acceptance of advertisement brochures was found to significantly reduce the level of agreement with the proposition that "A physician should not accept any gift from a drug company." (0.3[0.1-0.9], p = 0.030). In summary, exposure to drug companies was widespread among our final year medical students who, like students in both Western and non-Western societies, hold permissive attitudes concerning accepting gifts, and drug advertising brochures may relax those permissive attitudes still further. Rational prescription training was useful in generating rational attitudes. Policies concerning drug company-medical student relationships should be developed in Turkey as well as internationally.
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Affiliation(s)
- Nazim Ercument Beyhun
- Karadeniz Technical University Medical Faculty Dep. Of Public Health, Trabzon, Turkey
- * E-mail:
| | - Cevriye Ceyda Kolayli
- Karadeniz Technical University Medical Faculty Dep. Of Public Health, Trabzon, Turkey
| | - Gamze Can
- Karadeniz Technical University Medical Faculty Dep. Of Public Health, Trabzon, Turkey
| | - Murat Topbas
- Karadeniz Technical University Medical Faculty Dep. Of Public Health, Trabzon, Turkey
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