Anderson Britta L, Silverman Gabriel K, Loewenstein George F, Zinberg Stanley, Schulkin Jay
The American College of Obstetricians, Washington, DC 20024, USA.
Acad Med. 2009 Aug;84(8):994-1002. doi: 10.1097/ACM.0b013e3181ace53a.
To examine relationships between pharmaceutical representatives and obstetrician-gynecologists and identify factors associated with self-reported reliance on representatives when making prescribing decisions.
In 2006-2007, questionnaires were mailed to 515 randomly selected physicians in the American College of Obstetricians and Gynecologists' Collaborative Ambulatory Research Network. Participants were asked about the information sources used when deciding to prescribe a new drug, interactions with sales representatives, views of representatives' value, and guidelines they had read on appropriate industry interactions.
Two hundred fifty-one completed questionnaires (49%) were returned. Seventy-six percent of participants see sales representatives' information as at least somewhat valuable. Twenty-nine percent use representatives often or almost always when deciding whether to prescribe a new drug; 44% use them sometimes. Physicians in private practice are more likely than those in university hospitals to interact with, value, and rely on representatives; community hospital physicians tend to fall in the middle. Gender and age are not associated with industry interaction. Dispensing samples is associated with increased reliance on representatives when making prescribing decisions, beyond what is predicted by a physician's own beliefs about the value of representatives' information. Reading guidelines on physician-industry interaction is not associated with less reliance on representatives after controlling for practice setting.
Physicians' interactions with industry and their familiarity with guidelines vary by practice setting, perhaps because of more restrictive policies in university settings, professional isolation of private practice, or differences in social norms. Prescribing samples may be associated with physicians' use of information from sales representatives more than is merited by the physicians' own beliefs about the value of pharmaceutical representatives.
研究医药代表与妇产科医生之间的关系，并确定在做出处方决策时自我报告依赖代表的相关因素。
2006年至2007年，向美国妇产科医师学会协作门诊研究网络中随机抽取的515名医生邮寄问卷。参与者被问及在决定开新药时使用的信息来源、与销售代表的互动、对代表价值的看法以及他们读过的关于适当行业互动的指南。
共收回251份完整问卷（49%）。76%的参与者认为销售代表的信息至少有些价值。29%的参与者在决定是否开新药时经常或几乎总是使用代表；44%的参与者有时使用。私人执业医生比大学医院的医生更有可能与代表互动、重视并依赖代表；社区医院医生的情况则介于两者之间。性别和年龄与行业互动无关。发放样品与在做出处方决策时对代表的依赖增加有关，超出了医生自身对代表信息价值的信念所预测的程度。在控制了执业环境后，阅读医生与行业互动指南与减少对代表的依赖无关。
医生与行业的互动以及他们对指南的熟悉程度因执业环境而异，这可能是由于大学环境中更严格的政策、私人执业的专业孤立或社会规范的差异。开处方样品可能与医生使用销售代表的信息有关，其程度超过了医生自身对医药代表价值的信念所应有的程度。
