The results of physician studies cannot be assumed to reflect NP practice

The influence of pharmaceutical company-sponsored educational programs and gifts on the prescribing practices of physicians, medical students, and residents is well documented.1 Nurse practitioners (NPs) also serve as prescribing providers to various patient populations and are also recipients of pharmaceutical company-sponsored education, sales visits, promotions, and gifts.2

While NPs' decision-making process for selecting medications for their patients is similar to those of physicians, studies show differences in NP prescribing patterns including an increased use of nonpharmacologic treatment modalities, selection of lower-priced prescription alternatives, and an increased use of educational materials.3-5 Although there are much data about physician prescribing beliefs and practices, the results of physician studies cannot be assumed to reflect NP practice.

Three hundred and ninety three (393) NPs responded to a survey designed to evaluate whether the receipt of pharmaceutical company-sponsored education, sales visits, promotional products, and gifts influenced their prescribing beliefs and practices. Survey results demonstrate that NPs are influenced by their interactions with pharmaceutical companies; however, like their physician colleagues, many NPs do not recognize that influence. While only 52% of the NP respondents felt they were influenced by their interactions with pharmaceutical companies, 80% stated they had changed their prescribing practices after an encounter with a pharmaceutical company representative or program. This is a statistically significant discrepancy between perceived influence and actual behavior change. Another key finding: only 20% of the respondents stated they had never changed their prescribing after a pharmaceutical encounter.

Pharmaceutical companies spend more than $15 billion annually to promote and market their products.6,7 Up to $8 billion of this amount is directed to healthcare providers who prescribe pharmaceuticals: physicians, NPs, and physician assistants.

NPs' interactions with pharmaceutical companies can result in increased access to medications for patients, educational opportunities for NPs, and educational resources for patients, and potentially more opportunities for NP-pharmaceutical company cooperation in education and research. The practicing NP, however, needs to be able to recognize and acknowledge the influence of pharmaceutical company promotions to best use the pharmaceutical company studies and information in service to their patients.

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