Learning Objective #1: Identify three influences affecting nurse practitioner prescribing practices

Learning Objective #2: Discuss two ways to increase nurse practitioners' understanding of pharmaceutical company influence on their prescribing practice

---

Pharmaceutical companies vie for the favor of healthcare providers in order to increase sales of their company's products. They use a number of tactics including providing educational programs, sales visits to practice sites, free drug samples and gifts to providers (Murray, 2002; Wazana, 2000; Wolf, 1998). They also market directly to patients through the media. The influence of pharmaceutical company sponsored education, promotions and gifts on the prescribing practices of physicians, medical students, and residents have been well documented in the literature. Nurse practitioners (NPs) also prescribe pharmaceutical products for their patients; yet the effect of corporate promotions on the prescribing practices of nurse practitioners has not been assessed. The purpose of this study was to investigate the relationship between pharmaceutical company sponsored educational programs, promotions and gifts and the self-reported prescribing beliefs and practices of certified nurse practitioners. One thousand certified NPs were surveyed. The states of Pennsylvania, New York and Florida were used due to high numbers of certified NPs in these states which also have urban, suburban and rural population centers. A 56% response rate was obtained. Results show 51% of NPs believe they are influenced by pharmaceutical company products, promotions, and gifts while 48% do not believe they are influenced. NPs in urban areas have more contact with pharmaceutical company representatives than their suburban or rural counterparts. Eighty percent of NPs report having changed or modified their prescribing practice after a pharmaceutical company interaction. This number is significantly higher than the number of NPs who report believing they are influenced by these encounters. Sixty percent of the respondents stated that having sample medications available in their office was very important or somewhat important in choosing which prescription drug to select for their patients. Implications for NP practice and education will be discussed.