Factors Affecting the Cardiologists' Prescribing Attitudes in Dubai and the Northern Emirates: A Cross-sectional Study

Abstract

Background The growing concern of irrational drug use that leads to adverse events requires attention to investigate the prescription patterns. For cardiovascular drugs, this could increase patients' risk of developing a heart attack or stroke and coronary artery disease. This study particularly examines cardiologist behaviors that influence prescription patterns. The influence of pharmaceutical companies' promotions and other factors affecting their prescriptions in the United Arab Emirates (UAE), mainly in Dubai and the Northern Emirates private hospitals and clinics, were investigated.

Methods Online survey questions were undertaken using the structured questionnaire, and the determined sample size of the cardiologists working in Dubai and the Northern Emirates was 59 using randomly generated numbers from the available cardiologists' registry and assuming 95% confident with the 80% response rate. Ratings of the prescribing behavior were done using the original Bloom's cutoff points, which were updated and adjusted to evaluate UAE cardiologists' general prescribing practices.

Results The average prescribing behavior score was moderate (76.5%; 95% confidence interval [CI], 75.1–77.8). Better prescribing patterns were observed among the cardiologists from Dubai compared with the Northern Emirates (odds ratio 4.24; 95% CI, 1.06–16.97). Continued medical education sponsored by pharmaceutical companies was the main influential factor (96.6%) affecting the cardiologists in changing their prescription. A total of 40.7% of the cardiologists believed in changing the prescription from brand to generic, while 43% stated that clinical updates, including evidence from new studies, were among the other factors affecting their prescribing behavior pattern.

Conclusion The cardiologists' prescribing behaviors in Dubai and the Northern Emirates are above average and the cardiologists are aware of the unethical acceptance of pricey gifts. Cardiologists in Dubai and the Northern Emirates are considered ethical in adopting a new medication in agreement with similar studies conducted regionally, as their primary motivation is the welfare of patients, which will help them rationally select medication.

Keywords

cardiologists - prescription pattern - attitude - pharmaceutical companies - clinical updates

Ethical Approval

None.

Publikationsverlauf

Artikel online veröffentlicht:
19. Juli 2023

• References

• 1 Schumock GT, Walton SM, Park HY. et al. Factors that influence prescribing decisions. Ann Pharmacother 2004; 38 (04) 557-562
• 2 Schwartz LM, Woloshin S. Medical marketing in the United States, 1997-2016. JAMA 2019; 321 (01) 80-96
• 3 Habibi R, Guénette L, Lexchin J, Reynolds E, Wiktorowicz M, Mintzes B. Regulating information or allowing deception? Pharmaceutical sales visits in Canada, France, and the United States. J Law Med Ethics 2016; 44 (04) 602-613
• 4 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
• 5 O'Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age Ageing 2008; 37 (02) 138-141
• 6 Raisch DW. A model of methods for influencing prescribing: part I. A review of prescribing models, persuasion theories, and administrative and educational methods. DICP 1990; 24 (04) 417-421
• 7 Zelnio RN. The interaction among the criteria physicians use when prescribing. Med Care 1982; 20 (03) 277-285
• 8 Miles DL. Multiple prescriptions and drug appropriateness. Health Serv Res 1977; 12 (01) 3-10
• 9 Brehaut JC, Poses R, Shojania KG. et al. Do physician outcome judgments and judgment biases contribute to inappropriate use of treatments? Study protocol. Implement Sci 2007; 2: 18
• 10 Gaziano T, Reddy KS, Paccaud F, Horton S, Chaturvedi V. Cardiovascular disease. In: Jamison DT, Breman JG, Measham AR. et al, eds. Disease Control Priorities in Developing Countries. 2nd ed.. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; 2006. :chapter 33
• 11 Shehab A, Kholy DE, Bakir S. et al. Prevalence of cardiovascular risk factors and 10-years risk for coronary heart disease in the United Arab Emirates. Curr Diabetes Rev 2023; 19 (03) 38-48
• 12 Karimi A, Haerizadeh M, Soleymani F, Haerizadeh M, Taheri F. Evaluation of medicine prescription pattern using World Health Organization prescribing indicators in Iran: a cross-sectional study. J Res Pharm Pract 2014; 3 (02) 39-45
• 13 Mahdaviazad H, Keshtkar V, Emami MJ. Osteoporosis guideline awareness among Iranian family physicians: results of a knowledge, attitudes, and practices survey. Prim Health Care Res Dev 2018; 19 (05) 485-491
• 14 Sharif SI, Alabdouli AH, Sharif RS. Drug prescribing trends in a general hospital in Sharjah, United Arab Emirates. Am J Pharmacol Sci 2013; 1 (01) 6-9
• 15 Khazzaka M. Pharmaceutical marketing strategies' influence on physicians' prescribing pattern in Lebanon: ethics, gifts, and samples. BMC Health Serv Res 2019; 19 (01) 80
• 16 Sharifnia SHA, Mohammadzadeh M, Arzani G. et al. Main factors affecting physicians' prescribing decisions: the Iranian experience. Iran J Pharm Res 2018; 17 (03) 1105-1115
• 17 Al-Mohamadi A, Al-Harbi AM, Manshi AM, Rakkah MM. Medications prescribing pattern toward insured patients. Saudi Pharm J 2014; 22 (01) 27-31
• 18 Lundin D. Moral hazard in physician prescription behavior. J Health Econ 2000; 19 (05) 639-662
• 19 Al Zahrani HS. The impact of pharmaceutical promotions on primary health care physician's prescribing behaviour in KAMC in central region. Int J Med Sci Public Health 2014; 3 (03) 358-361