Caudill T S, Johnson M S, Rich E C, McKinney W P
Department of General Internal Medicine, University of Kentucky, Lexington, USA.
Arch Fam Med. 1996 Apr;5(4):201-6. doi: 10.1001/archfami.5.4.201.
To evaluate the influence of primary care physicians' attitudes toward and use of information provided by pharmaceutical representatives on prescribing costs in ambulatory practice.
A mailed questionnaire collected information about physician demographic and practice characteristics and attitudes toward and use of information provided by pharmaceutical representatives.
Kentucky physicians practicing primary care adult medicine (family medicine, general practice, general medicine; n = 1603).
Relative cost of prescribing, based on physician responses to treatment choices for ambulatory clinical scenarios in primary care. A multivariable regression model assessed predictive relationships between independent variables and prescription costs.
Four hundred forty-six returned questionnaires were suitable for analysis. No significant differences were noted in age, gender, days worked per week, or years since graduation between responders and a sample of nonresponders. A significant positive correlation was found between physician cost of prescribing and perceived credibility, availability, applicability, and use of information provided by pharmaceutical representatives (P < .01, Pearson's Product-Moment Correlation Coefficient). Physicians in academic or hospital-based practice settings had significantly lower prescribing costs than physicians in nonacademic and nonhospital practices (P = .001, analysis of variance). Frequency of use of information provided by pharmaceutical representatives (P = .01, multiple linear regression) and the group practice setting (P = .02, multiple linear regression) remained significant, independent positive predictors of cost in the multivariable regression model.
Frequency of use of information provided by pharmaceutical representatives and the group practice, nonacademic and nonhospital setting may be associated with increased primary care physician prescribing costs.
评估基层医疗医生对药品代表提供信息的态度及使用情况对门诊实践中处方成本的影响。
通过邮寄问卷收集医生的人口统计学和执业特征信息，以及对药品代表提供信息的态度和使用情况。
肯塔基州从事成人基层医疗的医生（家庭医学、普通科、普通内科；n = 1603）。
根据医生对基层医疗门诊临床情景治疗选择的回答得出的处方相对成本。多变量回归模型评估自变量与处方成本之间的预测关系。
446份返回的问卷适合进行分析。应答者与未应答者样本在年龄、性别、每周工作天数或毕业年限方面未发现显著差异。医生的处方成本与对药品代表提供信息的可信度、可用性、适用性及使用情况之间存在显著正相关（P <.01，Pearson积矩相关系数）。在学术或医院执业环境中的医生处方成本显著低于非学术和非医院执业环境中的医生（P =.001，方差分析）。在多变量回归模型中，药品代表提供信息的使用频率（P =.01，多元线性回归）和团体执业环境（P =.02，多元线性回归）仍然是成本的显著独立正向预测因素。
药品代表提供信息的使用频率以及团体执业、非学术和非医院环境可能与基层医疗医生处方成本增加有关。
