1. Patient’s Attitudes Towards Gifts to Physicians
Jinender Kumar, B. Pharm. D.M.M, MS Candidate, Sharrel Pinto, Ph.D, Assistant Professor
Department of Pharmacy Health Care Administration
College of Pharmacy, University of Toledo, Toledo, OH, USA
Research Description Data Analysis
Data will be entered and analyzed using SPSS version 15. A priori alpha level of 0.05 will be used.
Background:
• Gifts provided to physicians are the most common marketing strategy used by pharmaceutical companies •Descriptive statistics will be used to describe the study sample
• In the past, many studies have discussed the attitudes of physicians, residents and medical students towards
•For objective 1 and 2, frequency distribution will be calculated
gifts giving1-5
• To date, there are only two studies available in literature that discussed patient’s attitudes towards gifts to •For objective 3 and 4, point-biserial correlation will be done
physicians6, 7
•Reliability of the survey instrument will be done using Cronbach’s alpha
Rationale:
• The acceptance of gifts from pharmaceutical companies causes a conflict of interest situation for physicians8
Survey
• Considering the fact that the increased cost of prescription drugs due to gifts giving is ultimately passed to the
patients9, it is important to study the patient’s attitudes
Significance:
• Previous studies have either used a telephonic survey limited to a particular area or surveyed patients at two
physicians sites. This study will be the first to use a mailed survey to a nationally representative sample of
patients
• The policy makers could incorporate the finding from this study to update the ethical guidelines on gifts to
physicians
Goal & Objectives
Goal:
• To determine patient’s attitudes towards gifts to physicians
Objectives:
• To determine patient’s awareness about specific gifts and drug samples given to physicians from pharmaceutical
industry
• To determine patient’s views about appropriateness of specific gifts and drug samples given to physicians from
pharmaceutical companies
• To determine the relationship between demographic variables* and patients attitudes towards gifts to physicians
• To determine the relationship between demographic variables* and patients belief that gifts to physicians
influences their prescribing behavior * - Age, Sex, Education level, self rated health, whether patients are currently taking prescription medication or not
Methods
Study Design:
• Exploratory Cross-sectional
Database:
• A National Database containing addresses of patients maintained by PCS mailing list company will be used to Limitations
draw a random sample of patients
• Patient records are updated quarterly in this database Low response Rate: Countered by increasing the sample size from 385 to 1350
Sample Size:
Non Response Bias: A reminder letter would be sent to all patients
A sample size of 385 is determined based on margin error of 5%, CI of 95% and response distribution of 50%.10 With
an estimated 5% oversampling and response rate of 30%, total number of surveys mailed will be 135011
References
1) Gibbons RV, Landry FJ, Blouch Dl, et al. A comparison of physicians and patients attitude towards pharmaceutical industry gifts. J Gen intern Med. 1998;13:151-4
2) Halperin, Edward C.; Hutchison, Paul; Barrier Jr, Robert C. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers. International Journal of Radiation Oncology, Biology and Physics. 2004;59(5):1477-1483
3) Sierles FS, Brodkey AC, Cleary LM, et al. Medical students' exposure to and attitudes about drug company interactions: A National Survey. JAMA. 2006;295(3):author reply 281-2
4) Ashmore, Russell; Carver, Neil; Banks, David Mental health nursing students' relationships with the pharmaceutical industry. Nurse Education Today. 2007:27(6):551-560
Brotzman GL, Mark DH. The effect of resident’s attitudes of regulatory policies regarding pharmaceutical representative’s activities. J Gen Intern Med. 1993;8:130-4
5)
6) Mainous AG 3rd, Hueston WJ, Rich EC. Patient perceptions of physician acceptance of gifts from the pharmaceutical industry. Archives of Family Medicine. 1995;4(4):335-9
7) Blake RL Jr, Early EK. Patients' attitudes about gifts to physicians from pharmaceutical companies. J Am Board Family Practice. 1995;8(6):457-64
Lemmens T, Liclur, LLM (Bioethics), Peter A. singer. Bioethics for clinicians; 17. Conflict of interest in research, education and patient care. CMAJ. 1998;159:960-5. Available at CMAJ’s website www.cmaj.ca/cmaj/series/bioethics.htm. Accessed on 27 Feb., 2008
8)
9) Lexchin J. Pharmaceutical promotion in Canada: convince them or confuse them. International Journal of Health services. 1987,17:77-79
10) Online sample size calculator. Available at: www.raosoft.com/samplesize/html. Accessed on Dec. 20, 2007
Presented at Midwest Social and Administrative Conference, Chicago, IL, July 23rd-25th, 2008
11) Harris IA, Khoo OK, Young JM, Solomon MJ, Rae H. Lottery incentive did not improve response rate to a mailed survey: a randomized clinical trial. Journal of Clinical Epidemiology. 2008;61:609-610