https://doi.org/10.4081/acbr.2022.241

Clinicians’ contribution to cost-related medication non-adherence: Impact of irrational prescribing and influence of pharmaceutical promotional activities on prescribing behavior of clinicians

Vol. 3 No. 3 (2022)
Submitted: 26 September 2022
Accepted: 12 December 2022
Published: 29 December 2022
irrational prescribing, medication non-adherence, clinicians, cost, pharmaceutical promotional activities
Abstract Views: 298
PDF: 88
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Paul Osemeke Nwani
paul.nwani@yahoo.com
https://orcid.org/0000-0002-1665-2738
Clinical Pharmacology/Neurology Units, Department of Internal Medicine, Nnamdi Azikiwe University Nnewi Campus, Awka, Anambra State, Nigeria.

Poor training of clinicians on the Rational Use of Medicines (RUMs) and the impact of pharmaceutical promotional activities fuel irrational prescribing behavior, which is a major contributor to cost-related medication non-adherence. The aim of this study was to determine how training on the RUMs and related concepts and the influence of pharmaceutical promotional activities impact on clinicians prescribing behavior, a major cause of cost-related medication non-adherence. This was a cross-sectional descriptive study, conducted among medical practitioners in South-eastern Nigeria using a self-administered questionnaire. The questions were designed to determine the clinicians’ knowledge and practice of the basic concepts of the RUMs, as well as how much pharmaceutical promotional activities (information and incentives) impact on their prescribing behaviors. There were 100 clinicians, 71 (71%) males and 29 (29%) females, with mean years of practice of 8.2±5.8 years. About 66% of the respondents claimed they were trained on the concept of the RUMs, however, only 20% were aware of the Personal Drugs (Pdrugs) concept, and 17% had their own list of P-drugs, which is basic to rational prescribing. Fifty-six percent (56%) agreed that pharmaceutical promotional activities influenced their prescribing habits, while 32% were indifferent. The poor knowledge of the basic concepts of the RUMs as seen in this study makes clinicians vulnerable to irrational prescribing and the negative impact of pharmaceutical promotional activities. In developing nations, where medicines are mostly paid out of pocket by the patient, such prescribing habits fuel cost-related medication non-adherence.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Briesacher BA, Gurwitz JH, Soumerai SB. Patients at-risk for cost-related medication nonadherence: a review of the literature. J Gen Intern Med 2007;22:864–71. DOI: https://doi.org/10.1007/s11606-007-0180-x
Hennessy DA, Sanmartin C, Ronksley P, et al. Out-of-pocket spending on drugs and pharmaceutical products and cost-related prescription non-adherence among Canadians with chronic disease. Health Rep 2016;27:3-8.
Morgan SG, Lee A. Cost-related non-adherence to prescribed medicines among older adults: a cross-sectional analysis of a survey in 11 developed countries. BMJ Open 2017;7:e014287. DOI: https://doi.org/10.1136/bmjopen-2016-014287
World Health Organization. Guide to Good Prescribing. Geneva: WHO; 1994. Available from: https://apps.who.int/iris/bitstream/handle/10665/59001/WHO_DAP_94.11.pdf
Bajait CS, Pimpalkhute SA, Sontakke SD, et al. Evaluation of knowledge, attitude and practice of rational use of medicines among clinicians in a tertiary care teaching hospital. Int J Nutr Pharmacol Neurol Dis 2014;4:153-7.
World Health Organization. The Rational Use of Drugs. Report of the Conference of Experts. Geneva: WHO; 1985. Available from: https://apps.who.int/iris/handle/10665/37174
Singh NR. P‑drug concept and the undergraduate teaching. Indian J Pharmacol 2008;40:285. DOI: https://doi.org/10.4103/0253-7613.45160
Ahmad SR, Bhutto ZA. A survey of pediatric prescribing and dispensing in Karachi. J Pakistan Med Assoc 1990;40:126-30.
Tomson G, Angunawela I. Patients, doctors and their drugs: a study at four levels of health care in an area of Sri Lanka. Euro J Clin Pharm 1990;39:463-7 DOI: https://doi.org/10.1007/BF00280937
Adair RF, Holmgren LR. Do drug samples influence residents’ prescribing behavior? A randomized controlled trial. Am J Med 2005;118:881-4. DOI: https://doi.org/10.1016/j.amjmed.2005.02.031
Morgan MA, Dana J, Loewenstein G, Zinberg S. Interactions of doctors with the pharmaceutical industry. J Med Ethics 2006;32:559-63. DOI: https://doi.org/10.1136/jme.2005.014480
World Health Organization. Ethical criteria for medicinal drug promotion. Geneva: WHO; 1988. Available from: https://apps.who.int/iris/bitstream/handle/10665/38125/924154239X_eng.pdf?sequence=1
Ziegler MG, Lew P, Singer BC. The accuracy of drug information from pharmaceutical drug representatives. JAMA 1995;273:1296-8. DOI: https://doi.org/10.1001/jama.273.16.1296
Avorn J, Chen M, Hartley R. Scientific versus commercial sources of influence on the prescribing behavior of physicians. Am J Med 1982;73:4-8. DOI: https://doi.org/10.1016/0002-9343(82)90911-1
Ijoma U, Onwuekwe I, Onodugo O, et al. Effect of Promotional Strategies of Pharmaceutical Companies on Doctors’ Prescription Pattern in South East Nigeria. TAF Prev Med Bull 2010;9:1-6
Raosoft (2004). Sample Size Calculator. 2004. Raosoft Inc., Seattle, USA. Available from: http://www.raosoft.com/samplesize.html
Statistical Package for Social Sciences (IBM SPSS), 22.0 version. Armonk, NY, USA: IBM Corp. 2013. Available from: https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-22
Odiase FE, Ogbemudia JE. Predictors of nonadherence to antihypertensive medications among stroke survivors in Benin City Nigeria. Sub-Saharan Afr J Med 2019;6:122-8 DOI: https://doi.org/10.4103/ssajm.ssajm_18_19
Ale OK, Busari AA, Irokosu ES, et al. Medication nonadherence in Nigerian heart failure patients: A cross sectional study. J Clin Sci 2021;18:155-60 DOI: https://doi.org/10.4103/jcls.jcls_1_21
Bajait CS, Pimpalkhute SA, Sontakke SD, et al. Evaluation of knowledge, attitude and practice of rational use of medicines among clinicians in a tertiary care teaching hospital. Int J Nutr Pharmacol Neurol Dis 2014;4:153-7. DOI: https://doi.org/10.4103/2231-0738.132673
Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. J Am Med Assoc 2007; 298:61–9. DOI: https://doi.org/10.1001/jama.298.1.61
Mindaugas S, Joaquim FS, Eija V, et al. Factors associated with refraining from buying prescribed medications among older people in Europe. Aust J Ageing 2014;33:E25–30. DOI: https://doi.org/10.1111/ajag.12075
Chew LD, O’Young TS, Hazlet TK, et al. A physician’s survey of the effect of drug sample availability on physicians’ behaviour. J Gen Intern Med 2000;15:478-83. DOI: https://doi.org/10.1046/j.1525-1497.2000.08014.x
Boltri JM, Gordon ER, Vogel RL. Effect of antihypertensive samples on physician prescribing patterns. Fam Med 2002;34:729-31.
Symm B, Averitt M, Forjuoh SN, Preece C. Effects of Using Free Sample Medications on the Prescribing Practices of Family Physicians. J Am Board Fam Med 2006;19:443-9. DOI: https://doi.org/10.3122/jabfm.19.5.443
Sergeant MD, Hodgetts P, Geoffrey GM, et al. Interactions with the pharmaceutical industry: a survey of family medicine residents in Ontario. Can Med Assoc J 1996;155:1243-8.
Keim SM, Arthur B, Witzke DB, et al. Beliefs and practices of emergency medicine faculty and residents regarding professional interaction with the biomedical industry. Ann Emerg Med1993;22:1576-81. DOI: https://doi.org/10.1016/S0196-0644(05)81262-4
Mainous AG, Hueston WJ, Rich EC. Patients’ perception of physicians’ acceptance of gifts from pharmaceutical industry. Arch Fam Med 1885;4:335-9. DOI: https://doi.org/10.1001/archfami.4.4.335

Supporting Agencies

None

How to Cite

Nwani, P. O. (2022). Clinicians’ contribution to cost-related medication non-adherence: Impact of irrational prescribing and influence of pharmaceutical promotional activities on prescribing behavior of clinicians. Annals of Clinical and Biomedical Research, 3(3). https://doi.org/10.4081/acbr.2022.241
Copyright (c) 2023 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.