PHYSICIANS BEHAVIOR AND THEIR INTERACTIONS WITH DRUG COMPANIES - A CONTROLLED-STUDY OF PHYSICIANS WHO REQUESTED ADDITIONS TO A HOSPITAL DRUG FORMULARY
PHYSICIANS BEHAVIOR AND THEIR INTERACTIONS WITH DRUG COMPANIES - A CONTROLLED-STUDY OF PHYSICIANS WHO REQUESTED ADDITIONS TO A HOSPITAL DRUG FORMULARY
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DOI：
10.1001/jama.271.9.684
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发表时间：
1994-03-02
影响因子：
120.7
通讯作者：
LANDEFELD, CS
中科院分区：
文献类型：
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作者：
CHREN, MM;LANDEFELD, CS
目的：医生与制药公司的互动是否会影响他们的行为，这一点存在争议。为了检验这种相互作用与医生行为无关的零假设，我们研究了一种行为：要求将一种药物添加到医院处方集中。设计。-巢式病例对照研究。环境。-大学医院。参与者：-全职主治医师。病例医生是 1989 年 1 月至 1990 年 10 月期间请求增加处方的所有 40 名医生。对照医生是随机选择的 80 名未提出请求的医生。主要暴露测量-医生与制药公司的互动，根据医生调查确定（答复率，88% [105/120]）。结果：要求将药物添加到处方集中的医生比其他医生更频繁地与制药公司互动；例如，他们更有可能接受公司的资助来参加教育研讨会或在教育研讨会上发言或进行研究（比值比 [OR]，5.1；95% 置信区间 [CI]，2.0 至 13.2）。此外，如果医生会见了特定公司的医药代表（OR，13.2；95% CI，4.8 至 36.3）或接受了这些公司的资金（OR，19.2；95% CI，2.3 至 156.9），那么他们比其他医生更有可能要求将特定公司生产的药物添加到处方集中。这些关联在控制潜在混杂因素的多变量分析中是一致的。此外，与要求其他公司生产的药品相比，医生更有可能要求他们见过其制药代表的公司（OR，4.9；95% CI，3.2至7.4）或接受过金钱的公司（OR，1.7；95% CI，1.0至2.7）添加处方。结论：医生要求将药物添加到医院处方集中的要求与医生与药物生产公司的互动密切相关。
Objective.-It is controversial whether physicians' interactions with drug companies affect their behavior. To test the null hypothesis, that such interactions are not associated with physician behavior, we studied one behavior: requesting that a drug be added to a hospital formulary. Design.-Nested case-control study. Setting.-University hospital. Participants.-Full-time attending physicians. Case physicians were all 40 physicians who requested a formulary addition from January 1989 through October 1990. Control physicians were 80 randomly selected physicians who had not made requests. Main Exposure Measure.-Physician interactions with drug companies, as determined by survey of physicians (response rate, 88% [105/120]). Results.-Physicians who had requested that drugs be added to the formulary interacted with drug companies more often than other physicians; for example, they were more likely to have accepted money from companies to attend or speak at educational symposia or to perform research (odds ratio [OR], 5.1; 95% confidence interval [CI], 2.0 to 13.2). Furthermore, physicians were more likely than other physicians to have requested that drugs manufactured by specific companies be added to the formulary if they had met with pharmaceutical representatives from those companies (OR, 13.2; 95% CI, 4.8 to 36.3) or had accepted money from those companies (OR, 19.2; 95% CI, 2.3 to 156.9). These associations were consistent in multivariable analyses controlling for potentially confounding factors. Moreover, physicians were more likely to have requested formulary additions made by the companies whose pharmaceutical representatives they had met (OR, 4.9; 95% CI, 3.2 to 7.4) or from whom they had accepted money (OR, 1.7; 95% CI, 1.0 to 2.7) than they were to have requested drugs made by other companies. Conclusion.-Requests by physicians that drugs be added to a hospital formulary were strongly and specifically associated with the physicians' interactions with the companies manufacturing the drugs.