Awareness and attitudes of the Lebanese population with regard to physician–pharmaceutical company interaction: a survey study

Abstract

ObjectiveTo assess the awareness and attitudes of the general public in Lebanon regarding the interactions between physicians and pharmaceutical companies.SettingPrimary healthcare clinics and shopping malls in the Greater Beirut Area.Participants263 participants completed the questionnaire, of whom 62% were female and 38% were male. Eligible participants were Arabic-speaking or English-speaking adults (age≥18 years) residing in Lebanon for at least 5 years.Primary and secondary outcome measuresAwareness, attitudes and beliefs of the general public.Results263 out of 295 invited individuals (89% completion rate) completed the questionnaire. While the majority of participants were aware of pharmaceutical company presence (or absence) in physicians' offices (range of 71–76% across questions), smaller percentages were aware of gift-related practices of physicians (range of 26–69% across questions). 40% thought that the acceptance of small gifts or meals by physicians is wrong/unethical. The percentage of participants reporting lower trust in physicians due to their participation in various pharmaceutical company-related activities ranged from 12% to 45% (the highest percentage being for large gifts). Participants who reported receiving free medication samples were significantly more likely to consider physicians' acceptance of small gifts as ‘not a problem’ than ‘unethical’ (OR=1.53; p=0.044).ConclusionsParticipants in our survey were generally more aware of pharmaceutical company presence (or absence) in physicians' offices than of gift-related practices of physicians. While the level of trust was not affected for the majority of participants for various types of interactions, it was affected the most for accepting large gifts.

Awareness and perceptions among members of a Japanese cancer patient advocacy group concerning the financial relationships between the pharmaceutical industry and physicians: a mixed-methods analysis of survey data

“…Although the awareness of the interactions in this study, such as receipt of stationeries (64.2%), travel fees (35.8%), lecture fees (25.3%), and disclosure of payments from Pharma to the healthcare sector (10.5%), were within the scope of previous studies (55–76%, 17–33.7%, 20–46%, 7.3–18.8%, respectively),[12, 22, 24, 38, 43, 44] the awareness of receiving drug samples (53.1%) was significantly lower than studies in the US (87–93.9%). [43, 45] In contrast, the awareness of physicians conducting research for Pharma (47.4%), receipt of meals (50.5%), and receipt of textbooks (45.3%) were higher than US and Lebanese studies (23–32%, 22–37%, 35–37%), respectively.…”

“…[43, 45] In contrast, the awareness of physicians conducting research for Pharma (47.4%), receipt of meals (50.5%), and receipt of textbooks (45.3%) were higher than US and Lebanese studies (23–32%, 22–37%, 35–37%), respectively. [38, 40, 43] The underlying reasons for such differences among countries are not obvious. Still, stationaries and educational gifts, which could be present in clinicians’ offices, were more likely to be recognized than personal payments for lectures, travel, or accommodations, a trend which we observed previously.…”

“…We compiled our cross-sectional questionnaire survey, taking into account previous studies and the local context of Japanese cancer care. [38, 39] The survey included 51 questions covering the following items: 1) the status of disease progression and demographic characteristics such as gender, education level, and medical history; 2) awareness of the physician-Pharma interactions, including physician receipt of gifts, payments and research rewards from Pharma (e.g., “Do you know that some physicians would receive pamphlets or leaflets concerning products manufactured by pharmaceutical companies from their sales representatives?” ) on a three-point Likert scale ( Yes, No, or Not sure ); 3) influence of the interactions’ on trust (e.g., “How would your trust in your physician be influenced if your physician received pamphlet or leaflet with information about the products from a pharmaceutical sales representative?” ) on a five-point Likert scale; 4) perception of trust and regulation on the interactions (e.g., “Stricter regulations about gifts, meals, and honoraria from pharmaceutical companies to physicians are needed.” ) on a five-point Likert scale; 5) attitude towards the industrial payments across professions (e.g., “It is problematic for physicians to receive gifts, meals, and other entertainment from pharmaceutical sales representatives.” ) on a five-point Likert scale; and 6) an open-ended question about participants’ perception on the FCOI between Pharma and physicians (“ Please freely describe your thoughts about non-research-related offerings from Pharma to a physician (e.g., gifts, free meals, monetary incentives for a lecture) ”). The survey questions are described in greater detail in the Supplementary Methods (Supplementary Material 1).…”

“…These data analyses were informed by similar previous studies reported by Ammous et al and Green et al[38, 40] All analyses, including descriptive statistics, were performed using Stata version 15 (STATA Corp., College Station, TX, United States). Conversion of JPY to USD used the 2019 average monthly exchange rate of 109.0 JPY per USD.…”

Attitudes and behaviours of physicians towards the relationship with the pharmaceutical industry in Saudi Arabia

“…This increase in the number of visits and the closer relationship raise concerns regarding violations of professional codes of ethics. Recently, many studies and reports have been published confirming industry influence on the objectivities and behaviors of physicians Research article (8)(9)(10)(11)(12)(13)(14)(15)(16). Many physicians frequently do not recognize that their decisions have been affected by commercial gifts and services and may in fact deny or minimize such influence.…”