What influences healthcare providers’ prescribing decisions? Results from a national survey

Price, Simani; O’Donoghue, Amie C.; Rizzo, Lou; Sapru, Saloni; Aikin, Kathryn J.

doi:10.1016/j.sapharm.2021.01.012

Cited by 14 publications

(11 citation statements)

References 43 publications

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“…Around 70% of the respondents showed their concerns when prescribing OLMU about its safety and efficacy in the treatment of FRHIs and consider that some OLMU could increase the likelihood of ADRs. Similar trend was observed in other studies revealing the concern of healthcare professionals toward the safety and efficacy issues of OLMU ( 16 , 24 , 25 ). There is not any clear description of the right to prescribe OLMU anywhere in the globe.…”

Section: Discussionsupporting

confidence: 89%

“…In Pakistan only physicians have prescription rights and by constraining the prescribing practice of OLMU by the physicians we can prevent the misuse of OLMU. Healthcare professionals are legally restricted to inform patients toward the jeopardies involved in using OLMU ( 24 , 25 ). The element the there is a lack of data available for using the OLMU must be reflected as a likelihood of hazards to the patient.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues

Shakeel

Iffat

Qamar

et al. 2022

Front. Public Health

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BackgroundOff-label medication usage (OLMU) is prevalent in the treatment of various diseases, including female reproductive health issues (FRHIs). However, there is a paucity of literature on the perspective of health professionals on this subject. The purpose of the current study was to assess gynecologists/obstetricians' knowledge, attitude and practice toward OLMU in the treatment of FRHIs.MethodsThe current cross-sectional study was conducted in September and October 2021, at five tertiary care hospitals (two public and three private sector), different clinics and maternity homes in a metropolitan city of Karachi, Pakistan. The target population was gynecologists, obstetricians and physicians/residents working in the ob/gyn department in various hospitals and clinical settings of Karachi.ResultsThe overall response rate was 77.1%. The mean age of the study respondents was 36.1 ± 7.7 years; n = 85 (55.9%) respondents were working in primary patient care. The majorly reported OLMU by the respondents were clomiphene citrate in unexplained infertility (n = 66; 43.4%), metformin to improve cycle regularity in females with polycystic ovary syndrome (PCOS) (n = 59; 38.8%) and letrozole to induce ovulation (n = 31; 20.4%). The majorly stated categories of OLMU were at a different dose (n = 95; 62.5%) and at different indications than approved to treat (n = 89; 58.5%). It was reported by the majority of the respondents (n = 95; 62.5%) that they do not follow any guidelines or regulations for OLMU in their work setting; however, the response was statistically varied with the working organization (CI 2.14–2.93; p = 0.037) and practice area (CI 2.85–4.32; p = 0.0001) of respondents.ConclusionsThe present study revealed that the respondents were well-familiar with the practice of OLMU in the treatment of FRHIs. They expressed their concerns about decreasing such practices by being involved in collective decision-making procedures, and they were inclined to accept initiatives aimed at ensuring drug safety in patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues

Shakeel

Iffat

Qamar

et al. 2022

Front. Public Health

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“…Over recent decades, reporting demonstrates that pharmaceutical company-directed promotional activities influence medical practice, including physician prescribing patterns. [1][2][3][4][5] These promotional activities vary, ranging from drug samples and printed brochures provided by company medical sales representatives (MSRs) to paid honoraria for lectures and manuscripts or arranging meals and travel accommodations. 6,7 Consequently, this potential influence on physician decision-making in clinical practice contributes to questions surrounding the appropriate relationship between physicians and pharmaceutical companies.…”

Section: Introductionmentioning

confidence: 99%

“…Over recent decades, reporting demonstrates that pharmaceutical company‐directed promotional activities influence medical practice, including physician prescribing patterns 1–5 . These promotional activities vary, ranging from drug samples and printed brochures provided by company medical sales representatives (MSRs) to paid honoraria for lectures and manuscripts or arranging meals and travel accommodations 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Japanese physicians' perceptions of conflicts of interest with pharmaceutical companies: Estimating two different questioning approaches

Saito,

Ozaki,

Murakami

et al. 2024

Health Planning & Management

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Despite being one of the world's largest pharmaceutical markets, interactions between Japanese physicians and pharmaceutical companies often remain opaque. Importantly, potential conflicts of interest associated with these interactions can compromise patient care and increase costs. We conducted an online survey of Japanese physicians to elucidate perspectives on pharmaceutical company promotional activities and how these influence physician prescribing patterns. Anticipating that physicians might downplay their reliance on, or the value of, pharmaceutical company‐provided information, the survey incorporated a direct questioning method and an unmatched count technique (UCT) to identify hidden perceptions on factors likely to influence prescribing. Overall, 1080 eligible physicians participated. Of these, 105 (9.7%) self‐identified as hospital directors or managers. Surprisingly, nearly twice as many participants responding to direct questioning (18.9%) versus those responding to the UCT (10.1%) asserted that information provided by pharmaceutical companies was important when prescribing medicine. Hospital directors or managers (adjusted odds ratio [adjOR] 2.56, 95% confidence interval [95% CI]: 1.00–6.54, reference = physician without title) and frequent interactions with pharmaceutical sales representatives (adjOR 5.96, 95% CI: 1.88–18.9, reference = rare interaction) significantly valued the information from sales representatives and sponsored lectures when considering prescribing decisions. Additionally, 77.1% of respondents believed that sales representatives provide fair, neutral, or relatively honest and unbiased information about their products. Few Japanese physicians acknowledged the influence of industry‐provided information on prescribing patterns. Our study uniquely applies two distinct question formats, providing a novel approach to understanding the depth of physician‐industry relationships and the effectiveness of various survey methodologies.

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“…1 A recent survey conducted by the United States Food and Drug Administration (FDA) on health care practitioners in the United States reported that 40% of physicians assistants, 41% of nurse practitioners, 30% of primary care physicians, and 24% of specialists indicated that they often did not know what an accelerated approval drug was or was not comfortable prescribing an accelerated approval drug. 4 One way to provide health care providers with more information on these accelerated approval drugs is through the drug's label.…”

mentioning

confidence: 99%

Accelerated approval drug labels often lack information for clinical decision‐making

et al. 2023

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Study objective We evaluated US Food and Drug Administration labels for drugs approved under the accelerated approval pathway and whether these labels contained in sufficient information regarding their accelerated approval. Design Retrospective, observational, cohort study. Data source Label information for drugs with an accelerated approved indication were ascertained from two online platforms: Drugs@FDA and FDA Drug Label Repository. Intervention Drugs with indications receiving accelerated approval after January 1, 1992, but had not received full approval by December 31, 2020. Measurements Outcomes include whether the drug label indicated the use of the accelerated approval pathway, identified the specific surrogate marker(s) that supported it, or described the clinical outcomes being evaluated in post‐approval commitment trials. Results 253 clinical indications corresponding to 146 drugs received accelerated approval. We identified a total of 110 accelerated approval indications across 62 drugs that had not received full approval by December 31, 2020. A total of 13% of labels for accelerated approved indications lacked sufficient information that approval was via the accelerated approval or based on surrogate outcome measures: 7% did not mention accelerated approval but described surrogate markers, 4% did not mention accelerated approval nor describe surrogate markers, and 2% mentioned accelerated approval but did not describe surrogate markers. No label described the clinical outcomes being evaluated in post‐approval commitment trials. Conclusion Labels for accelerated approved clinical indications that do not yet have full approval should be revised to include the information required in the FDA guidance to help guide clinical decision‐making.

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What influences healthcare providers’ prescribing decisions? Results from a national survey

Cited by 14 publications

References 43 publications

Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues

Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues

Japanese physicians' perceptions of conflicts of interest with pharmaceutical companies: Estimating two different questioning approaches

Accelerated approval drug labels often lack information for clinical decision‐making

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