哪些因素影响医疗保健提供者的处方决策？一项全国性调查的结果。
What influences healthcare providers' prescribing decisions? Results from a national survey.
机构信息
Westat, Inc., Rockville, MD, USA.
U.S. Food and Drug Administration, Silver Spring, MD, USA.
出版信息
Res Social Adm Pharm. 2021 Oct;17(10):1770-1779. doi: 10.1016/j.sapharm.2021.01.012. Epub 2021 Jan 28.
BACKGROUND
Prior U.S. Food and Drug Administration (FDA) surveys with healthcare providers (HCPs) have focused on attitudes toward direct-to-consumer advertising and have not specifically examined professionally-targeted prescription drug promotion. Similarly, there are no recent national surveys of HCPs examining their interactions with the pharmaceutical industry.
OBJECTIVES
The goal of this study was to use a national sample of HCPs to examine exposure to professionally-targeted prescription drug promotions and interactions with industry, and knowledge, attitudes and practices related to FDA approval of prescription drugs.
METHODS
An online national survey was conducted with 2000 HCPs representing primary care physicians (PCPs), specialists (SPs), physician assistants (PAs), and nurse practitioners (NPs). The sample was randomly drawn from WebMD's Medscape subscriber network, stratified by HCP group, and designed to yield target numbers of completed surveys in each group. Weights were computed to correct for unequal selection probabilities, differential response rates, and differential coverage and used to generalize completed surveys to a national population of PCPs, SPs, NPs, and PAs.
RESULTS
Exposure and attention to pharmaceutical promotions and contact with industry were significantly associated with reported increase in pharmaceutical industry influence on decisions about prescription drugs. SPs were significantly more likely to prescribe off-label and serve as opinion leaders for the pharmaceutical industry compared to other provider groups.
CONCLUSIONS
Findings indicate pharmaceutical promotions directed at HCPs occur in many forms and are disseminated through multiple channels. By using a nationally representative sample of HCPs, this study provides population-level estimates for exposure and attention to prescription drug promotion and contact with industry and evidence for their influence on prescriber decisions. Findings from this study will help to inform FDA of HCP responses to and impacts of prescription drug promotion.
背景
先前美国食品和药物管理局（FDA）对医疗保健提供者（HCP）的调查侧重于对直接面向消费者的广告的态度，而并未专门研究针对专业人员的处方药促销活动。同样，目前也没有针对 HCP 的最新全国性调查，调查他们与制药行业的互动情况。
目的
本研究的目的是使用全国范围内的 HCP 样本，研究他们接触专业定向的处方药促销活动以及与行业互动的情况，以及与 FDA 批准处方药相关的知识，态度和实践。
方法
我们对 2000 名 HCP 进行了一项在线全国性调查，这些 HCP 代表了初级保健医生（PCP），专科医生（SP），医师助理（PA）和执业护士（NP）。该样本是从 WebMD 的 Medscape 订户网络中随机抽取的，按 HCP 群体进行分层，并设计了每个群体中完成调查的目标数量。计算了权重以纠正选择概率，响应率，覆盖范围和使用差异，并将完成的调查推广到全国范围内的 PCP，SP，NP 和 PA 人群。
结果
接触和关注药品促销活动以及与行业的联系与报告的药品行业对处方药决策的影响增加明显相关。与其他医疗服务提供者群体相比，专科医生更有可能开出非标签药物并成为制药行业的意见领袖。
结论
研究结果表明，针对 HCP 的药品促销活动以多种形式进行，并通过多种渠道传播。通过使用具有全国代表性的 HCP 样本，本研究提供了针对处方药促销和与行业接触的人群水平估计以及对处方决策者的影响的证据。这项研究的结果将有助于 FDA 了解 HCP 对处方药促销的反应和影响。
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