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Patient’s Attitudes Towards Gifts to Physicians Jinender Kumar, B. Pharm. D.M.M, MS Candidate, Sharrel Pinto, Ph.D, Assistant Professor Department of Pharmacy Health Care Administration College of Pharmacy, University of Toledo, Toledo, OH, USA References 1) Gibbons RV, Landry FJ, Blouch Dl, et al. A comparison of physicians and patients attitude towards pharmaceutical industry gifts. J Gen intern Med. 1998;13:151-4 2) Halperin, Edward C.; Hutchison, Paul; Barrier Jr, Robert C. A population-based study of the prevalence and influence of gifts to radiation oncologists from pharmaceutical companies and medical equipment manufacturers. International Journal of Radiation Oncology, Biology and Physics. 2004;59(5):1477-1483 3) Sierles FS, Brodkey AC, Cleary LM, et al. Medical students' exposure to and attitudes about drug company interactions: A National Survey. JAMA. 2006;295(3):author reply 281-2 4) Ashmore, Russell; Carver, Neil; Banks, David Mental health nursing students' relationships with the pharmaceutical industry. Nurse Education Today. 2007:27(6):551-560 5) Brotzman GL, Mark DH. The effect of resident’s attitudes of regulatory policies regarding pharmaceutical representative’s activities. J Gen Intern Med. 1993;8:130-4 6) Mainous AG 3rd, Hueston WJ, Rich EC. Patient perceptions of physician acceptance of gifts from the pharmaceutical industry. Archives of Family Medicine. 1995;4(4):335-9 7) Blake RL Jr, Early EK. Patients' attitudes about gifts to physicians from pharmaceutical companies. J Am Board Family Practice. 1995;8(6):457-64 8) Lemmens T, Liclur, LLM (Bioethics), Peter A. singer. Bioethics for clinicians; 17. Conflict of interest in research, education and patient care. CMAJ. 1998;159:960-5. Available at CMAJ’s website www.cmaj.ca/cmaj/series/bioethics.htm. Accessed on 27 Feb., 2008 9) Lexchin J. Pharmaceutical promotion in Canada: convince them or confuse them. International Journal of Health services. 1987,17:77-79 10) Online sample size calculator. Available at: www.raosoft.com/samplesize/html. Accessed on Dec. 20, 2007 11)Harris IA, Khoo OK, Young JM, Solomon MJ, Rae H. Lottery incentive did not improve response rate to a mailed survey: a randomized clinical trial. Journal of Clinical Epidemiology. 2008;61:609-610 Data Analysis Data will be entered and analyzed using SPSS version 15. A priori alpha level of 0.05 will be used. • Descriptive statistics will be used to describe the study sample • For objective 1 and 2, frequency distribution will be calculated • For objective 3 and 4, point-biserial correlation will be done • Reliability of the survey instrument will be done using Cronbach’s alpha Background: • Gifts provided to physicians are the most common marketing strategy used by pharmaceutical companies • In the past, many studies have discussed the attitudes of physicians, residents and medical students towards gifts giving 1-5 • To date, there are only two studies available in literature that discussed patient’s attitudes towards gifts to physicians 6, 7 Rationale: • The acceptance of gifts from pharmaceutical companies causes a conflict of interest situation for physicians 8 • Considering the fact that the increased cost of prescription drugs due to gifts giving is ultimately passed to the patients 9 , it is important to study the patient’s attitudes Significance: • Previous studies have either used a telephonic survey limited to a particular area or surveyed patients at two physicians sites. This study will be the first to use a mailed survey to a nationally representative sample of patients • The policy makers could incorporate the finding from this study to update the ethical guidelines on gifts to physicians Research Description Goal: • To determine patient’s attitudes towards gifts to physicians Objectives: • To determine patient’s awareness about specific gifts and drug samples given to physicians from pharmaceutical industry • To determine patient’s views about appropriateness of specific gifts and drug samples given to physicians from pharmaceutical companies • To determine the relationship between demographic variables* and patients attitudes towards gifts to physicians • To determine the relationship between demographic variables* and patients belief that gifts to physicians influences their prescribing behavior * - Age, Sex, Education level, self rated health, whether patients are currently taking prescription medication or not Goal & Objectives Methods Study Design: • Exploratory Cross-sectional Database: • A National Database containing addresses of patients maintained by PCS mailing list company will be used to draw a random sample of patients • Patient records are updated quarterly in this database Sample Size: A sample size of 385 is determined based on margin error of 5%, CI of 95% and response distribution of 50%. 10 With an estimated 5% oversampling and response rate of 30%, total number of surveys mailed will be 1350 11 Survey Limitations Low response Rate: Countered by increasing the sample size from 385 to 1350 Non Response Bias: A reminder letter would be sent to all patients Presented at Midwest Social and Administrative Conference, Chicago, IL, July 23 rd -25 th , 2008
