Background: The interaction between physicians and medical representatives (MRs) through gift\noffering is a common cause for conflicts of interest for physicians that negatively influence prescribing\nbehaviors of physicians throughout the world. This study aimed to evaluate the interaction\nbetween MRs and Iraqi specialist physicians through the acceptance of MRs gifts and the effect\nof such acceptance on physician�s prescribing patterns. Methods: A survey in a questionnaire\nformat for specialist physicians was done during March-October 2013 in Iraq, Baghdad. The questionnaire\ninvolves four major parts regarding the approximate number of patients and medical\nrepresentatives, gift acceptance, medical conferences, and prescribing pattern. Results: In Iraq\nspecialist physicians were visited by 1 - 3 MRs/day. 50% of the Iraqi physicians like to get the\neducational information by attending conferences outside Iraq. Regarding Gift acceptance, 41% of\nparticipated physicians showed a general acceptance to promotional gifts, and 91% of physicians\naccept low cost gifts but only 41% of them accept high cost recreational gifts. Free samples were\nused by 59% of Iraqi physicians to treat some people. 77% of physicians prefer prescribing new\nmedications, while more than 95% of participated physicians stated that they stop prescribing\nthese new drugs either due to their ineffectiveness or due to their side effects. On the other hand\nphysicians significantly change their prescribing behavior through shifting not only among generic\ndrugs, but also from brand to generic drugs in their prescriptions. Gift acceptance is directly\ncorrelated with such shift and change in prescribing behavior. Conclusion: Iraqi physicians accept\nvarious types of gifts from pharmaceutical companies; this can influence physician prescribing\npattern and result in early adoption to prescribe newly medications depending on promotional\ninformation even in absence of clinical evidence about the drug effectiveness or side effects, which\nmay result in undesirable outcomes to the patient.
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