Gibbons R V, Landry F J, Blouch D L, Jones D L, Williams F K, Lucey C R, Kroenke K
Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA.
J Gen Intern Med. 1998 Mar;13(3):151-4. doi: 10.1046/j.1525-1497.1998.00048.x.
To compare physicians' and their patients' attitudes toward pharmaceutical gifts.
Survey of physicians and their patients.
Two tertiary-care medical centers, one military and one civilian.
Two hundred sixty-eight of 392 consecutively surveyed physicians, 100 of 103 randomly selected patients at the military center, and 96 patients in a convenience sample at the civilian center completed the survey.
Participants rated 10 pharmaceutical gifts on whether they were appropriate for physicians to accept and whether they were likely to influence prescribing. Patients found gifts less appropriate and more influential than did their physicians. About half of the patients were aware of such gifts; of those unaware, 24% responded that this knowledge altered their perception of the medical profession. Asked whether they thought their own physician accepted gifts, 27% said yes, 20% no, and 53% were unsure. For patients, feeling that gifts were inappropriate was best predicted by a belief that gifts might influence prescribing, while for physicians, the best predictor was knowledge of guidelines.
Patients feel pharmaceutical gifts are more influential and less appropriate than do their physicians. Physicians may want to consider this in deciding whether to accept particular gifts. Broader dissemination of guidelines may be one means of changing physician behavior. At the same time, future guidelines should further consider the potentially different viewpoints of patients and physicians.
比较医生及其患者对医药礼品的态度。
对医生及其患者进行调查。
两家三级医疗中心,一家军队医院和一家 civilian(此处可能有误,推测为“民营”或“地方”)医院。
在连续调查的392名医生中,有268名完成了调查;在军队医院随机抽取的103名患者中,有100名完成了调查;在民营医院便利样本中的96名患者完成了调查。
参与者对10种医药礼品在医生是否适合接受以及是否可能影响处方开具方面进行评分。患者认为礼品比医生认为的更不合适且更具影响力。约一半的患者知晓此类礼品;在那些不知情的患者中,24%的人表示这一认知改变了他们对医疗行业的看法。当被问及他们是否认为自己的医生接受礼品时,27%的人回答是,20%的人回答否,53%的人不确定。对于患者而言,认为礼品不合适的最佳预测因素是相信礼品可能影响处方开具,而对于医生来说,最佳预测因素是对指南的了解。
患者认为医药礼品比医生认为的更具影响力且更不合适。医生在决定是否接受特定礼品时可能需要考虑这一点。更广泛地传播指南可能是改变医生行为的一种方式。同时,未来的指南应进一步考虑患者和医生潜在的不同观点。