Factors Influencing Hematologists-Oncologists’ Prescription of Chemotherapy Drugs in Cancer Treatment in Iran: an Interview Questionnaire Study Factors influencing hematologists-oncologists’ prescription of chemotherapy drugs
Iranian Journal of Pharmaceutical Sciences,
Vol. 13 No. 1 (2017),
1 January 2017
,
Page 7-22
https://doi.org/10.22037/ijps.v13.40702
Abstract
Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy, and targeted therapy. The choice of treatment depends on the type and stage of the cancer. Chemotherapy drugs play an important role in cancer treatment. The objective of this interview-questionnaire study is to explore what influences Iranian hematologists-oncologists’ prescription when prescribing chemotherapy drug. Data collection can be divided into two categories: the interview and the questionnaire. The qualitative part consists of depth interviews, utilizing closed- and open-ended questions, were conducted with oncologists, selected through theoretical sampling. The interview questions consisted of two parts, in the first part; open-ended questions were posed about factors influencing prescription. In the second part, the oncologists were asked to rate predefined factors that might influence their prescription decisions. The quantitative part of the study consists of questionnaire included two parts; the first part consisted of general questions including gender, age, membership in scientific committees and professional background. The second part consisted of 24 specialized questions that covered all the indexes of the effective factors on oncologists’ prescription decisions. Ten oncologists were interviewed. Factors affecting chemotherapy drug prescription were grouped into three categories based on qualitative studies carried out and is presented as they were mentioned and rated by the hematologists-oncologists: 1) Products properties, 2) Pharmaceutical marketing, 3) Scientific, experimental confirmation. The findings from the questionnaire suggest products properties particularly (clinical effectiveness) is the most important factor considered in drug prescription choice. Also, the socialized medicine sponsorship and clinical trial respectively are the most effective on increasing the frequency of prescribing. Whilst, prescribing by brand name or higher prices for a drug are not necessarily justified. The results of this study provide new insights to the nature prescribing behavior driven to develop measures which could be used to achieve greater clinical effectiveness and economic efficiency from drug prescribing.
- Chemotherapy drug
- Clinical effectiveness
- Interview
- Pharmaceutical marketing
- Prescribing behavior
- Questionnaire.
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References
[2] Gehlbach S, Wilkison W, Clapp N, et al. Taylor W, Rodell M. Improving Drug Prescribing in a Primary Care Practice. Med Care. 1984; 22: 193-201.
[3] Shamim-ul-Haq S, Ahmed RR, Ahmad N, et al. Factors Influencing Prescription Behavior of Physicians. Pharma Innovation. 2014; 3(5): 30-35.
[4] Caves RE, Whinston MD, Hurwitz MA, et al. Patent expiration, entry and competition in the U.S. pharmaceutical industry. Brookings Papers on Economic Activity: Microeconom. 1991; 62-64.
[5] Bagwell K. the Economic Analysis of Advertising. In: Armstrong M and Porter R. (Eds.) Handbook of Industrial Organization. Oxford, UK Elsevier. 2007; 1701-1844.
[6] Berger JT. Pharmaceutical industry influences on physician prescribing: gifts, quasi-gifts, and patient-directed gifts. Am J Biotech. 2003; 3: 56-57.
[7] De Bakker D, Coffie D, Heerdink E, et al. Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis. BMC Health Services Research. 2007; 7: 132.
[8] Zivin K. How are prescribing decisions made? Psychiatr. Serv. 2013; 64: 295-303.
[9] Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J ClinPharmac. 1995; 39(1): 1-6.
[10] Theodorou M, Tsiantou V, Pavlakis A, et al. Factors influencing prescribing behaviour of physicians in Greece and Cyprus: results from a questionnaire based survey. BMC Health Serv Res. 2009; 9:150.
[11] Soremekun R, Omitiran B. Factor’s affecting physicians' prescription and pattern of prescription in the management of secondary infertility. Afr J Pharm Pharmacol. 2014; 8(48): 1205-1212.
[12] Reichert S, Simon T, Halm E. Physicians' Attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med. 2000; 160 (18): 2799-2803.
[13] Buusman A, Andersen M, Merrild C, et al. Factors influencing GPs' choice between drugs in a therapeutic drug group. A qualitative study. Scand J Prim Health Care. 2007; 25:208-213.
[14] Korenstein D, Keyhani S, Ross JS. Physician attitudes toward industry: a view across the specialties. Arch Surg. 2010;145(6):570-577.
[15] Lieb K, Brandtonies S. A Survey of German Physicians in Private Practice about Contacts with Pharmaceutical Sales Representatives. DtschArztebl Int. 2010; 107(22): 392–398.
[16] Kalkan A, Roback K, Hallert E, et al. Factors influencing rheumatologists’ prescription of biological treatment in rheumatoid arthritis: an interview study. Implement Sci. 2014; 9:153-164.
[17] Pedan A, Wu H. Asymmetric Responsiveness of Physician Prescription Behavior to Drug Promotion of Competitive Brands within an Established Therapeutic Drug Class. Health Mark Q. 2011; 28:133–154.
[18] Cancer: WHO Factsheet 2014; 297.
[19] Morgan G, Wardy R, Bartonz M. The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies. J ClinOncol. 2004; 16: 549-560.
[20] Van Leeuwen RWF, Swart EL, Boom FA, et al. Potential drug interactions and duplicate prescriptions among ambulatory cancer patients: a prevalence study using an advanced screening method. BMC cancer. 2010; 10:679-683.
[21] Nilsson JLG, Andersson K, Bergkvist A, et al. Refill adherence to repeat prescriptions of cancer drugs to ambulatory patients. J. Cancer Care(Engl).2006;15:235–237
[22] Babbie E. The practice of social research. 6th ed. Belmont (CA): Wadsworth Publishing Company.1992.
[23] Ostlund U, Kidd L, Wengstrom Y, et al. Combining qualitative and quantitative research within mixed method research designs: A methodological review. Int J Nurs Stud.2011; 48: 369–383.
[24] Morgan DL. Paradigms lost and pragmatism regained: methodological implications of combining qualitative and quantitative methods. J Mix Methods Res. 2007; 1(1):48–76.
[25] Onwuegbuzie AJ, Leech NL. On becoming a pragmatic researcher: the importance of combining quantitative and qualitative methodologies. Int J Soc Res Meth. 2005; 8(5):375–387.
[26] Charmaz k. Grounded Theory as an Emergent Method. In S. N. H ESSE-Biber&P.Leavy (Eds), Handbook of Emergent Methods. New York: The Guilford Prees.2008.
[26] Likert R. A Technique for the measurement of attitudes. ArchPsychol. 1932; 22(140): 1-55.
[27] Brown JD. Likert items and scales of measurement? SHIKEN: JALT Testing & Evaluation SIG Newsletter.2011; 15(1):10-14.
[28] De Laat E. How does pharmaceutical marketing influence doctors' prescribing behaviour? Den Haag: CentraalPlanbureau.2002.
[29] Johnson JR, Ning YM, Farrell A, et al. Accelerated approval of oncology products: the food and drug administration experience. J Natl Cancer Inst. 2011; 103:636-644.
[30] Cronbach L. Coefficient alpha and the internal structure of tests. Psychomerika. 1951; 16:297-334.
[31] Streiner D. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J. Pers. Assess. 2003; 80:99-103.
[32] de Bakker DH, Coffie DS, Heerdink ER, et al. Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis. BMC Health Serv Res. 2007; 7: 132.
[33] Narendran R, Narendranathan M. Influence of pharmaceutical marketing on prescription practices of physicians. J Indian Med Assoc. 2013; 111(1):47-50.
[34] Manchanda P, Phil M, Honka E. The Effects and Role of Direct-to-Physician Marketing in the Pharmaceutical Industry: An Integrative Review. Yale J Health Policy Law Ethics.2005; 5(2):785-822.
[35] Nair HS, Manchanda P, Bhatia T. Asymmetric social interactions in physician prescription behavior: The role of opinion leaders. J Mark Res.2009; 2:38.
[36] Gonül FF, Carter F, Petrova E, et al. Promotion of Prescription Drugs and its Impact on Physicians’ Choice Behavior J Market. 2001; 65(3):79-90.
[37] Downing NS, Aminawung JA, Shah ND, et al. Clinical Trial Evidence Supporting FDA Approval of Novel Therapeutic Agents. 2005-2012. J Am Med Assoc. 2014; 311(4):368-377.
[38] Meropol NJ, Buzaglo JS, Millard J, et al. Barriers to clinical trial participation as perceived by oncologists and patients. J NatlComprCancNetw.2007; 5:655–664.
[39] Creswell JW. A qualitative, quantitative and mixed method approaches .4 th ed. Thousand Oaks, CA: Sage.2013.
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