The Association of Pharmaceutical Company Promotional Spending With Resident Physician Prescribing Behavior

Huang, Frederick Y.; Weiss, Daniel S.; Fenimore, Paul G.; Fleming, Anne M.; Haller, Ellen; Lichtmacher, Jonathan; Eisendrath, Stuart J.

doi:10.1176/appi.ap.29.5.500

Cited by 12 publications

(9 citation statements)

References 6 publications

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“…Five found positive associations with prescribing frequency [28],[31],[43],[60],[65]. Three studies did not detect a significant association [33],[39],[40].…”

Section: Resultsmentioning

confidence: 90%

“…Following application of inclusion/exclusion criteria and quality appraisal, 58 studies were included in the review (52 published in journals [25]–[33],[35]–[77], three reports [78]–[80], one dissertation [34], one conference presentation [81], and one conference poster [82] (Figure 1). Of these 58, 29 studies came from database searches [25]–[31],[33],[35]–[38],[41],[44],[55],[56],[59]–[62],[66]–[68],[70]–[72],[74],[76],[77], 22 studies came from reference lists [32],[39],[40],[46]–[54],[58],[63]–[65],[69],[73],[75],[78],[79], five studies came from experts in the field [34],[43],[57],[81],[82], and two from email lists [45],[80]. These 58 studies included 87 units of analysis.…”

Section: Resultsmentioning

confidence: 99%

“…51 studies [25]–[54],[56]–[60],[62],[63],[65],[67]–[70],[72],[73],[75]–[81] measured prescribing frequency as market share, intention to prescribe, prescription sales, formulary requests, as well as number of prescriptions (63 units of analysis) (Table 8). Below we report separately the results of studies of information delivered with versus without conventional promotion.…”

Section: Resultsmentioning

confidence: 99%

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Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review

et al. 2010

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Geoff Spurling and colleagues report findings of a systematic review looking at the relationship between exposure to promotional material from pharmaceutical companies and the quality, quantity, and cost of prescribing. They fail to find evidence of improvements in prescribing after exposure, and find some evidence of an association with higher prescribing frequency, higher costs, or lower prescribing quality.

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“…Five found positive associations with prescribing frequency [28],[31],[43],[60],[65]. Three studies did not detect a significant association [33],[39],[40].…”

Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review

et al. 2010

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“…24 Residents' prescription practices are influenced by their interactions with the pharmaceutical industry, 25,26 and residents are likely to receive biased information from industry-sponsored educational events. Lithium, as an older, generic medication, is not actively marketed in contrast to other BD medications.…”

Section: Discussionmentioning

confidence: 99%

US Psychiatric Residents’ Treatment of Patients With Bipolar Disorder

Rakofsky

Dunlop

2012

Journal of Clinical Psychopharmacology

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We aimed to evaluate the practice patterns of US postgraduate year (PGY) levels 3 and 4 psychiatric residents in the treatment of patients with bipolar disorder (BD) types I and II. We also aimed to determine whether confidence in prescribing mood stabilizers is associated with residents' practice patterns. The residency training directors of 182 Accreditation Council for Graduate Medical Education-accredited US psychiatric residencies were solicited for study participation via e-mail. Their chief residents were asked to forward an online survey Web link to all PGY-3 and PGY-4 residents in their program. The survey was a cross-sectional, online questionnaire, evaluating residents' treatment choices for their BD patients in their psychopharmacology clinics during the last academic year (July 1, 2009, to May 1, 2010), along with resident confidence level in using mood stabilizers. The survey Web link was distributed to 769 residents, and 177 (23.0%) responded to the survey. The percentage of residents who did not initiate treatment in the past year with mood stabilizers was 24.5% for lithium, 26.9% for lamotrigine, 36.7% for valproate, and 73.6% for carbamazepine. Confidence in initiating treatment with each of the 4 mood stabilizers was significantly associated with the number of patients treated with each mood stabilizer in the past year. Residents reported having the lowest confidence with carbamazepine followed by lamotrigine, lithium, and valproate. Experience prescribing first-line treatments for BD, such as lithium and valproate, is inadequate for many US psychiatric residents. Psychiatry residency directors should ensure that their residents have sufficient opportunity to pharmacologically treat BD patients so that these young physicians may develop confidence using an array of evidence-based treatments.

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“…2 Prescribing patterns are influenced by pharmaceutical company promotion -or why would companies spend this money? 3 Jefferson 4 and Chan 5 both report declining psychiatry resident knowledge about, and use of, older medications (including lithium) despite evidence supporting their continued use; we are unclear why Adetunji et al find this literature 'patronising' . We agree with them, however, that psychiatrists should base treatment choices on individual patient characteristics as well as the profile of medicines.…”

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confidence: 99%