title: Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey.
abstract: BACKGROUND
  Commercial sources of information are known to have greater influence than scientific sources on general practitioners' (GPs) prescribing behavior in under developed and developing countries. The study aimed to determine the self-reported impact of pharmaceutical promotion on the decision-making process of prescription of GPs in Eastern Turkey.
  
  
  METHODS
  A cross-sectional, exploratory survey was performed among 152 GPs working in the primary health centers and hospitals in Erzurum province of Eastern Turkey in 2006. A self-administered structured questionnaire was used. The questionnaire included questions regarding sociodemographics, number of patients per day, time per patient, frequency of sales representative visits to GPs, participation of GPs in training courses on prescribing (in-service training, drug companies), factors affecting prescribing decision, reference sources concerning prescribing and self-reported and self-rated effect of the activities of sales representatives on GPs prescribing decisions.
  
  
  RESULTS
  Of 152 subjects, 53.3% were male and 65.8% were working at primary health care centers, respectively. Mean patient per day was 58.3 +/- 28.8 patients per GP. For majority of the GPs (73.7%), the most frequent resource used in case of any problems in prescribing process was drug guides of pharmaceutical companies. According to self-report of the GPs, their prescribing decisions were affected by participation in any training activity of drug companies, frequent visits by sales representatives, high number of patient examinations per day and low year of practice (p < 0.05 for all).
  
  
  CONCLUSIONS
  The results of this study suggest that for the majority of the GPs, primary reference sources concerning prescribing was commercial information provided by sales representatives of pharmaceutical companies, which were reported to be highly influential on their decision-making process of prescribing by GPs. Since this study was based on self-report, the influence reported by the GPs may have been underestimated.
authors.affiliation: Department of Public Health in Ataturk University, School of Medicine, Erzurum, Turkey. svanceli@atauni.edu.tr <svanceli@atauni.edu.tr>
authors.forename: Serhat
authors.initials: S
authors.lastname: Vancelik
authors.forename: Nazim E
authors.initials: NE
authors.lastname: Beyhun
authors.forename: Hamit
authors.initials: H
authors.lastname: Acemoglu
authors.forename: Oksan
authors.initials: O
authors.lastname: Calikoglu
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003657:Decision Making; D016527:Drug Costs; D004345:Drug Industry / Q000191:economics*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005194:Family Practice / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D040541:Marketing; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011795:Surveys and Questionnaires; D014421:Turkey; D019037:Urban Health Services