Knowledge, Beliefs and Attitudes of Patients and the General Public towards the Interactions of Physicians with the Pharmaceutical and the Device Industry: A Systematic Review

Abstract

ObjectiveTo systematically review the evidence on the knowledge, beliefs, and attitudes of patients and the general public towards the interactions of physicians with the pharmaceutical and the device industry.MethodsWe included quantitative and qualitative studies addressing any type of interactions between physicians and the industry. We searched MEDLINE and EMBASE in August 2015. Two reviewers independently completed data selection, data extraction and assessment of methodological features. We summarized the findings narratively stratified by type of interaction, outcome and country.ResultsOf the 11,902 identified citations, 20 studies met the eligibility criteria. Many studies failed to meet safeguards for protecting from bias. In studies focusing on physicians and the pharmaceutical industry, the percentages of participants reporting awareness was higher for office-use gifts relative to personal gifts. Also, participants were more accepting of educational and office-use gifts compared to personal gifts. The findings were heterogeneous for the perceived effects of physician-industry interactions on prescribing behavior, quality and cost of care. Generally, participants supported physicians’ disclosure of interactions through easy-to-read printed documents and verbally. In studies focusing on surgeons and device manufacturers, the majority of patients felt their care would improve or not be affected if surgeons interacted with the device industry. Also, they felt surgeons would make the best choices for their health, regardless of financial relationship with the industry. Participants generally supported regulation of surgeon-industry interactions, preferably through professional rather than governmental bodies.ConclusionThe awareness of participants was low for physicians’ receipt of personal gifts. Participants also reported greater acceptability and fewer perceived influence for office-use gifts compared to personal gifts. Overall, there appears to be lower awareness, less concern and more acceptance of surgeon-device industry interactions relative to physician-pharmaceutical industry interactions. We discuss the implications of the findings at the patient, provider, organizational, and systems level.

Evidencia sobre conflictos de intereses en medicina

“…On the other hand, DeGeorge et al 33 found that studies that report conflict of interest are more likely to show a favorable outcome regarding infections (p<0.01), wound complications (p<0.01), overall morbidity (p<0.07) and mortality (p<0.05). 33 Finally, the review by Fadlallah et al 41 showed that patients and the general public care very little about the personal gifts their physicians receive from the pharmaceutical industry, and that when studies focus on surgeons, patients believe that professionals decide what is best for their health, regardless of their financial relationship with the industry.…”

Knowledge and attitude towards dentist-industry relationship and their association with own behavior among dentists working in Saudi Arabia

“…A study (Fadlallah et al, 2016) found that participants’ awareness on physician’s receipt of gifts was low. It also reported less concern, lower awareness and more acceptance of surgeon-device industry relative to physician-pharmaceutical industry interactions.…”

Pharmaceutical companies and healthcare providers: Going beyond the gift – An explorative review

“…Conversely, others view the opposing logics in both organizations as insurmountable and suggest that interactions between pharmaceutical companies and healthcare providers are primarily geared towards promoting the products of the pharmaceutical company, which conflicts with the social responsibility of healthcare providers. Empirically, studies find that interaction between pharmaceutical companies and healthcare providers could result in a conflict of interests (COI), negatively alter physicians’ prescribing behavior, or result in a negative perception towards professionals [ 22 , 29 – 35 ]. As a result, several guidelines have been created to help professionals navigate the opposing explanations of interactions with pharmaceutical companies [ 36 – 38 ].…”