Department of General Medicine and Primary Care, Tsukuba Medical Center Hospital, Ibaraki, Japan.
PLoS One. 2010 Aug 13;5(8):e12193. doi: 10.1371/journal.pone.0012193.
Previous surveys on the relationship between physicians and pharmaceutical representatives (PRs) have been of limited quality. The purpose of our survey of practicing physicians in Japan was to assess the extent of their involvement in pharmaceutical promotional activities, physician characteristics that predict such involvement, attitudes toward relationships with PRs, correlations between the extent of involvement and attitudes, and differences in the extent of involvement according to self-reported prescribing behaviors.
From January to March 2008, we conducted a national survey of 2621 practicing physicians in seven specialties: internal medicine, general surgery, orthopedic surgery, pediatrics, obstetrics-gynecology, psychiatry, and ophthalmology. The response rate was 54%. Most physicians met with PRs (98%), received drug samples (85%) and stationery (96%), and participated in industry-sponsored continuing medical education (CME) events at the workplace (80%) and outside the workplace (93%). Half accepted meals outside the workplace (49%) and financial subsidies to attend CME events (49%). Rules at the workplace banning both meetings with PRs and gifts predicted less involvement of physicians in promotional activities. Physicians valued information from PRs. They believed that they were unlikely to be influenced by promotional activities, but that their colleagues were more susceptible to such influence than themselves. They were divided about the appropriateness of low-value gifts. The extent of physician involvement in promotional activities was positively correlated with the attitudes that PRs are a valuable source of information and that gifts are appropriate. The extent of such involvement was higher among physicians who prefer to ask PRs for information when a new medication becomes available, physicians who are not satisfied with patient encounters ending only with advice, and physicians who prefer to prescribe brand-name medications.
Involvement in pharmaceutical promotional activities is widespread among practicing physicians in Japan. The extent of such involvement varies according to certain physician characteristics. As a group, they are at risk for influence by promotional activities.
以往关于医生与医药代表（PR）关系的调查质量有限。我们对日本执业医生进行了这项调查，旨在评估他们参与医药推广活动的程度、预测这种参与的医生特征、对与 PR 关系的态度、参与程度与态度之间的相关性，以及根据自我报告的处方行为而存在的参与程度差异。
2008 年 1 月至 3 月，我们对 7 个专科的 2621 名执业医生进行了一项全国性调查，包括内科、普通外科、骨科、儿科、妇产科、精神科和眼科。应答率为 54%。大多数医生与 PR 会面（98%）、接受药品样本（85%）和文具（96%），并参加工作场所（80%）和工作场所外（93%）的行业赞助继续医学教育（CME）活动。有一半人接受工作场所外的餐饮（49%）和参加 CME 活动的经济补贴（49%）。工作场所禁止与 PR 会面和收受礼物的规定预测医生参与推广活动的程度较低。医生重视 PR 提供的信息。他们认为自己不太可能受到推广活动的影响，但他们的同事比自己更容易受到影响。他们对低价值礼物的适当性存在分歧。医生参与推广活动的程度与 PR 是有价值信息来源和礼物是适当的态度呈正相关。当有新药物上市时更喜欢向 PR 询问信息的医生、对仅提供建议的患者就诊结束感到不满意的医生和更喜欢开品牌药物的医生，其参与程度更高。
在日本，执业医生广泛参与医药推广活动。这种参与程度因某些医生特征而异。作为一个群体，他们面临着受到推广活动影响的风险。
