Larkin James, Pericin Ivana, Collins Maurice, Smith Susan M, Byrne David, Moriarty Frank
Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland.
BJGP Open. 2021 Oct 26;5(5). doi: 10.3399/BJGPO.2021.0057. Print 2021 Oct.
The pharmaceutical industry invests heavily in promoting medications to physicians. This promotion may influence physicians' prescribing behaviour and lead to inappropriately increased prescribing rates.
To understand GPs' experience of interacting with the pharmaceutical industry, and explore their views and perceptions of the impact of this interaction in general practice in Ireland.
DESIGN & SETTING: A qualitative design was used, and GPs practicing in Ireland were eligible.
A combination of purposive and snowball sampling techniques was applied and semi-structured interviews were conducted. Thematic analysis was used to develop themes from the data.
Twenty-one GPs and one GP trainee participated. Five themes were developed: 1) GP and pharmaceutical industry interface; 2) the industry's methods of influence; 3) the uncomfortable relationship between GPs and industry; 4) GPs' perceptions of being unconsciously influenced; and 5) GPs' lack of knowledge of relevant regulations.Participants interacted with pharmaceutical representatives in their surgery and through continuing professional development (CPD). Reported methods of influence included biased information and the offer of gifts. Most participants felt their prescribing was unconsciously influenced. A minority felt that they were only influenced in a way that improved their prescribing.
The study shows that there can be a lack of clarity among GPs about relevant regulations and about the potential impact on prescribing of interactions with the pharmaceutical industry. Education of trainees and GPs has the potential to address this. Restrictions on interactions with the pharmaceutical industry may also play a role, although alternative CPD funding sources would need to be established.
制药行业在向医生推广药物方面投入巨大。这种推广可能会影响医生的处方行为，导致不适当的处方率上升。
了解全科医生与制药行业互动的经历，并探讨他们对这种互动在爱尔兰全科医疗中所产生影响的看法和认知。
采用定性设计，在爱尔兰执业的全科医生符合条件。
运用目的抽样和滚雪球抽样技术相结合的方法，并进行半结构化访谈。采用主题分析法从数据中提炼主题。
21名全科医生和1名全科医生实习生参与了研究。提炼出五个主题：1）全科医生与制药行业的界面；2）行业的影响方式；3）全科医生与行业之间令人不适的关系；4）全科医生对受到无意识影响的认知；5）全科医生对相关法规缺乏了解。参与者在诊疗室以及通过持续专业发展（CPD）与制药代表进行互动。报告的影响方式包括有偏见的信息和赠送礼品。大多数参与者认为他们的处方受到了无意识的影响。少数人觉得他们只是受到了以改善处方方式的影响。
该研究表明，全科医生对于相关法规以及与制药行业互动对处方的潜在影响可能缺乏清晰认识。对实习生和全科医生进行教育有可能解决这一问题。对与制药行业互动的限制或许也能发挥作用，不过需要建立替代的继续职业发展资金来源。
