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Drug Promotion - What We Know, What We Have Yet to Learn - Reviews of Materials in the WHO/HAI Database on Drug Promotion - EDM Research Series No. 032
(102 pages)

Table of Contents
View the documentAcknowledgements
View the documentExecutive summary
Open this folder and view contentsIntroduction
close this folderReview 1. What attitudes do professional and lay people have to promotion?
View the document1.1 Attitudes do not necessarily match behaviour
View the document1.2 Studies of the prevalence of different attitudes to promotion (excluding direct-to-consumer advertising)
View the document1.3 Do trainers and trainees think that sales representatives should be banned during medical training?
View the document1.4 Do doctors think they have enough training to deal with sales representatives?
View the document1.5 Do doctors think that sales representatives have a valuable role in medical education?
View the document1.6 What do health professionals think about the quality of the information provided by sales representatives and advertisements about drugs?
View the document1.7 What do other groups of people think of promotional information?
View the document1.8 What are doctors’ views of pharmaceutical company support of conferences and speakers?
View the document1.9 Do trainee doctors plan to see sales representatives in their future practice?
View the document1.10 What are professionals’ and patients’ attitudes to the appropriateness of gifts?
View the document1.11 Do health professionals feel that discussions with sales representatives affect prescribing?
View the document1.12 Do people feel that accepting gifts influences prescribing?
View the document1.13 Ethics and promotion
View the document1.14 Attitudes to direct-to-consumer advertising of prescription drugs
View the document1.15 Studies of differences in attitudes to promotion (excluding DTCA)
View the documentSummary of conclusions
View the documentDirections for future research
Open this folder and view contentsReview 2. What impact does pharmaceutical promotion have on attitudes and knowledge?
Open this folder and view contentsReview 3. What impact does pharmaceutical promotion have on behaviour?
Open this folder and view contentsReview 4. What interventions have been tried to counter promotional activities, and with what results?
View the documentFinal conclusions
View the documentReferences

1.11 Do health professionals feel that discussions with sales representatives affect prescribing?

Thirty-five per cent of the psychiatry trainees in Hodges’ study4 agreed that discussions with sales representatives did not influence their prescribing behaviour. This attitude was less prevalent among more senior trainees. Among the Canadian family medicine residents in the Sergeant et al.5 study, 34% agreed and 43% disagreed that sales representatives influenced their prescribing habits. In emergency medicine, Keim et al.10 found that 75% of programme directors, but only 49% of residents, believed that marketing techniques affect residents' prescribing practices. Seventy per cent of the Canadian doctors surveyed by Strang et al.13 agreed that sales representatives affected physicians’ prescribing habits. Thirty-one per cent of the internal medicine residency programme directors surveyed by Lichstein et al. were concerned, and 13% were very concerned, about the impact of sales representatives on the attitudes and prescribing behaviours of their residents14. Most directors of family practice residency programmes in the USA (56%) felt that the information and resources provided by sales representatives affected the prescribing of residents and practicing doctors17.

Bansinath et al.35 state that only 5-6% of Indian cardiologists report that medical sales representatives had played a role in their decisions to prescribe brand or generic drugs. Sixty-three per cent of doctors in a Turkish city surveyed by Güldal and Semin27 felt that information from sales representatives did not influence their prescribing. Those who found information from sales representatives reliable tended to report that this information had more influence on them.

American general practitioners surveyed by Pitt and Nel36 rated sales representatives as the third most important influence on their prescribing decisions, advertisements as fifth and gifts as sixth. However, this study had a low response rate and excluded journal articles in the list of possible influences. Clinical pharmacists involved in family medicine residency programmes, surveyed by Hume and Shaughnessy37, rated sales representatives, along with journal articles, as the third most important source of drug information influencing the prescribing of family medicine residents.

In Sigworth et al.’s32 study of resident doctors in Virginia in 2000, 91% reported that sales representatives had some effect on their prescribing. The authors suggest that this high rate could be the result of recent publicity and discussion on these issues, although the residents had not had formal educational sessions on drug promotion.

CONCLUSION: Many doctors denied that they were influenced by drug representatives: in three studies of residents 34, 49 and 91% believed they were affected, in three groups of programme directors 75, 31 and 56% did so. The available data suggest that doctors may be more willing to say that other doctors are influenced than they are themselves, but this remains a hypothesis.

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Last updated: May 4, 2012