Blake R L, Early E K
Department of Family and Community Medicine, University of Missouri-Columbia 65212, USA.
J Am Board Fam Pract. 1995 Nov-Dec;8(6):457-64.
Little is known about patients' awareness of and attitudes about gifts to physicians from pharmaceutical companies.
During a 7-week period in summer 1994, we surveyed adults (18 years of age and older) in the waiting rooms of two family practice centers in central Missouri. Four-hundred eighty-six adults (83 percent participation rate) responded to a self-administered questionnaire that assessed awareness of and attitudes about representative gifts.
Rates of awareness of specific gifts were 87.0 percent for free drug samples, 55.3 percent for ballpoint pens, 34.6 percent for medical books, 28.6 percent for baby formula, 22.4 percent for dinner at a restaurant, and 13.8 percent for a coffee maker. Of the 486 respondents, the following percentages were reported that "it is not all right" for physicians to accept specific gifts: dinner at a restaurant, 48.4 percent; baby formula, 44.2 percent; coffee maker, 40.7 percent; ballpoint pens, 17.5 percent; medical books, 16.9 percent; drug samples, 7.6 percent. In addition, 32.5 percent did not approve of their physicians accepting payment by a pharmaceutical company of medical conference expenses and from 28.0 percent to 43.4 percent disapproved of their physicians attending specific social events sponsored by pharmaceutical companies at a medical conference. Seventy percent of the subjects believed that gifts sometimes or frequently influence a physician's prescribing of medication; 64.0 percent believed that gifts to physicians increase the cost of medication. Beliefs that gifts influence prescribing behavior and beliefs that gifts increase medication costs were strongly associated with disapproval of each gift except for drug samples.
Respondents distinguished between particular gifts; approval rates were high for gifts generally considered to be trivial or that have potential value to patient care; disapproval rates were relatively high for gifts that have some monetary value but have little or no benefit for patients. Opinions about gifts were related to perceptions of their effects on prescribing behavior and costs.
患者对制药公司给医生送礼物的认知和态度鲜为人知。
1994年夏天的7周时间里,我们在密苏里州中部的两家家庭医疗中心的候诊室对成年人(18岁及以上)进行了调查。486名成年人(参与率83%)回答了一份自我管理的问卷,该问卷评估了对代表礼物的认知和态度。
对特定礼物的知晓率分别为:免费药品样本87.0%、圆珠笔55.3%、医学书籍34.6%、婴儿配方奶粉28.6%、餐厅晚餐22.4%、咖啡机13.8%。在486名受访者中,报告认为医生接受特定礼物“不合适”的比例如下:餐厅晚餐48.4%;婴儿配方奶粉44.2%;咖啡机40.7%;圆珠笔17.5%;医学书籍16.9%;药品样本7.6%。此外,32.5%的人不赞成他们的医生接受制药公司支付的医学会议费用,28.0%至43.4%的人不赞成他们的医生参加制药公司在医学会议上举办的特定社交活动。70%的受试者认为礼物有时或经常会影响医生的用药处方;64.0%的人认为给医生送礼物会增加药品成本。认为礼物会影响处方行为以及认为礼物会增加药品成本的观点,与除药品样本外对每种礼物的不赞成态度密切相关。
受访者对特定礼物进行了区分;对于通常被认为微不足道或对患者护理有潜在价值的礼物,赞成率较高;对于有一定货币价值但对患者几乎没有或没有益处的礼物,不赞成率相对较高。对礼物的看法与对其对处方行为和成本影响的认知有关。