title: Associations between generic substitution and patients' attitudes, beliefs and experiences.
abstract: BACKGROUND
  Generic substitution has been implemented in many countries, but knowledge about patients' attitudes, beliefs and experiences is still sparse.
  
  
  OBJECTIVE
  To assess associations between generic switching and patients' attitudes, beliefs and experiences with previous generic switching.
  
  
  METHODS
  A cross-sectional study comprising questionnaire responses from 2,476 randomly selected patients aged 20 years or older and living in the Region of Southern Denmark, who had redeemed substitutable drugs.
  
  
  METHODS
  The questionnaire included items on beliefs about medicine, views on generic medicine and confidence in the healthcare system. Only prescriptions issued by the general practitioners were included. For each patient, we focused on one purchase of a generically substitutable drug (index drug). Patients were identified by means of a dispensing database.
  
  
  RESULTS
  Earlier generic switches within the index ATC code were statistically significantly associated with experience of a generic switch (adjusted OR 5.93; 95 % CI 4.70-7.49). Having had more than five earlier switches within other ATC codes and having negative views on generic medicines reduced the odds of experiencing a generic switch. No associations were found between generic substitution and gender, drug group, number of different drugs used by the patient, confidence in the health care system and beliefs about medicine in general.
  
  
  CONCLUSIONS
  Patients who had once experienced a generic switch were more likely to accept a future generic switch within the same ATC code. Negative views on generic medicines were negatively associated with switching, while beliefs about medicine and confidence in the healthcare system had no influence.
authors.affiliation: Institute of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark, jrathe@health.sdu.dk.
authors.forename: Jette
authors.initials: J
authors.lastname: Rathe
authors.forename: Pia
authors.initials: P
authors.lastname: Larsen
authors.forename: Morten
authors.initials: M
authors.lastname: Andersen
authors.forename: Maja
authors.initials: M
authors.lastname: Paulsen
authors.forename: Dorte
authors.initials: D
authors.lastname: Jarbøl
authors.forename: Janus
authors.initials: J
authors.lastname: Thomsen
authors.forename: Jens
authors.initials: J
authors.lastname: Soendergaard
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D062313:Databases, Pharmaceutical; D003718:Denmark; D057915:Drug Substitution / Q000706:statistics & numerical data; D016568:Drugs, Generic / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D063046:Patient Medication Knowledge; D011795:Surveys and Questionnaires; D013810:Therapeutic Equivalency; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D016568:Drugs, Generic