Green Michael J, Masters Rebecca, James Benjamin, Simmons Bree, Lehman Erik
Department of Humanities, Penn State College of Medicine, Hershey, PA 17033, USA. mjg15psu.edu
Fam Med. 2012 May;44(5):325-31.
Gifts to physicians from the pharmaceutical industry are receiving increased scrutiny, but no previous research has evaluated the effect of such gifts on trust. The goal of this study is to determine patient awareness of interactions between physicians and the pharmaceutical industry and to learn whether those interactions impact trust and the doctor-patient relationship.
A cross-sectional, self-administered 61-item survey was administered in five outpatient clinic waiting rooms at a US medical center in 2008. A total of 220 consecutive English-speaking adults were invited to participate. Main outcome measures included: (1) Awareness of physician relationship with the pharmaceutical industry, (2) Attitudes about physician acceptance of gifts, (3) Perceived impact of gifts on trust in physicians, and (4) Effect of gifts on intent to adhere to physician recommendations.
A total of 192 individuals participated (87% response rate). While most were unaware of particular interactions between physicians and the pharmaceutical industry (12% to 60%, depending on activity), approximately half (51%) wanted to know if their physician accepted gifts >$100. A majority indicated they would have less trust in their physician if they learned he or she: accepted gifts >$100 (59%) or went on industry-sponsored trips (58%) or sporting events (54%). Further, 25% said they would be less likely to take a prescribed medication if their physician had recently accepted a gift in return for listening to a pharmaceutical representative's presentation about that drug.
Accepting gifts from the pharmaceutical industry has implications for the doctor-patient relationship. Doing so can undermine trust and affect patients' intent to adhere to medical recommendations.
医药行业给予医生的礼品正受到越来越多的审查，但此前尚无研究评估此类礼品对信任的影响。本研究的目的是确定患者对医生与医药行业之间互动的认知，并了解这些互动是否会影响信任及医患关系。
2008年在美国一家医疗中心的五个门诊候诊室进行了一项横断面、自我管理的61项调查。共邀请了220名连续就诊的英语成年患者参与。主要观察指标包括：（1）对医生与医药行业关系的认知；（2）对医生接受礼品的态度；（3）礼品对医生信任度的感知影响；（4）礼品对遵循医生建议意愿的影响。
共有192人参与（应答率87%）。虽然大多数人并不知晓医生与医药行业之间的具体互动情况（根据活动不同，知晓率在12%至60%之间），但约一半（51%）的人想知道他们的医生是否接受价值超过100美元的礼品。大多数人表示，如果得知医生：接受价值超过100美元的礼品（59%）、参加行业赞助的旅行（58%）或体育赛事（54%），他们对医生的信任会降低。此外，25%的人表示，如果他们的医生最近接受了礼品以换取听取药品代表关于某种药物的介绍，他们服用处方药的可能性会降低。
接受医药行业的礼品会对医患关系产生影响。这样做会破坏信任并影响患者遵循医疗建议的意愿。
