Interaction and medical inducement between pharmaceutical representatives and physicians: a meta-synthesis

Abstract

BackgroundIt has been proven that the interaction between pharmaceutical representatives and physicians can directly influence the latter’s prescribing behaviour. This meta-synthesis aims to explore the available studies regarding the nature of the interaction that takes place between pharmaceutical representatives and physicians. It highlights the different aspects of that interaction by investigating the reasons why these meetings happen in the first place, their benefits and drawbacks and their impact on patients’ health and, ultimately, the health of the public.MethodsA search for published articles was conducted in April 2015. Three databases (PubMed, Ovid Medline, and ProQuest) were searched for articles published between January 2000 and April 2015. Authors worked autonomously and in pairs to select eligible articles. In this case, the meta-synthesis approach was used to develop a fuller understanding and to facilitate new knowledge by bringing together qualitative findings on physician-PR interaction. ‘Meta-synthesis’ is the process of amalgamation of a group of similar studies with the aim of developing an explanation for their findings (Walsh and Downe, J Advanc Nurs 50: 204–211, 2005). A thematic content analysis was conducted on the 15 included full text articles (qualitative and quantitative studies) whereby the original authors’ understanding of key concepts in each study was identified and listed in a summary form in the data extraction sheet under “key findings” column. These findings were then juxtaposed to identify homogeneity and dissonance (Walsh and Downe, J Advanc Nurs 50: 204–211, 2005). Homogenous findings were then coded together on a different data extraction table to form a theme.ResultsA total of 15 articles met the inclusion criteria and were included in this meta-synthesis;six from the United States, two from Libya, and one each from Turkey, Peru, India, Germany, the United Kingdom, Yemen, and Japan. Six main themes were derived from the included articles: 1-the frequency of pharmaceutical representatives’ visits, 2-the perceived ethical acceptability of the interactions between pharmaceutical representatives and physicians, 3-the attitudes held by physicians towards visits by pharmaceutical representatives, 4-their perception of the effect of such visits on prescription patterns, 5-reasons to accept or reject pharmaceutical representatives, and lastly, 6-guidelines.ConclusionsThe physicians referred to pharmaceutical representatives as efficient and convenient information resources and were willing to meet them and accept their gifts. It was also evident that most physicians believed that their prescribing would not be influenced by pharmaceutical representatives.Electronic supplementary materialThe online version of this article (doi:10.1186/s40545-016-0089-z) contains supplementary material, which is available to authorized users.

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“…The high rate of prescribing in accordance with the Botswana EDL compares favourably with WHO recommendations of 100% as well as rates of 55%‐80% reported for the Africa, Europe, Americas and South East Asia regions . The high prescribing rate from the EDL could be attributed to easy accessibility of the Botswana Treatment Guidelines at PHC facilities, the routine availability of medicines incorporated into the Botswana EDL in PHCs, and the limited influence of pharmaceutical companies unlike other countries …”

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“…Drug marketing, in the process of simplifying the acquisition and evaluation of new product information [3,4], has a fundamental task to make the clinical answers and pharmacological solutions look simple. Today, drug marketing exerts a significant effect on the knowledge and awareness of physicians [3,4]. Despite a number of clear downsides [3,4], drug marketing is perceived as being associated with several advantages that, according to physicians, include easy exposure to new information, time saved on searching and accessing journal articles, easiness to remember the new information, and facilitated access to information on alternative pharmacological agents and strategies [3,4].…”

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