PMID- 25769055
OWN - NLM
STAT- MEDLINE
DCOM- 20150526
LR  - 20220310
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Print)
IS  - 0025-7079 (Linking)
VI  - 53
IP  - 4
DP  - 2015 Apr
TI  - Antipsychotic prescribing: do conflict of interest policies make a difference?
PG  - 338-45
LID - 10.1097/MLR.0000000000000329 [doi]
AB  - BACKGROUND: Academic medical centers (AMCs) have increasingly adopted conflict of 
      interest policies governing physician-industry relationships; it is unclear how 
      policies impact prescribing. OBJECTIVES: To determine whether 9 American 
      Association of Medical Colleges (AAMC)-recommended policies influence 
      psychiatrists' antipsychotic prescribing and compare prescribing between academic 
      and nonacademic psychiatrists. RESEARCH DESIGN: We measured number of 
      prescriptions for 10 heavily promoted and 9 newly introduced/reformulated 
      antipsychotics between 2008 and 2011 among 2464 academic psychiatrists at 101 
      AMCs and 11,201 nonacademic psychiatrists. We measured AMC compliance with 9 AAMC 
      recommendations. Difference-in-difference analyses compared changes in 
      antipsychotic prescribing between 2008 and 2011 among psychiatrists in AMCs 
      compliant with >/= 7/9 recommendations, those whose institutions had lesser 
      compliance, and nonacademic psychiatrists. RESULTS: Ten centers were AAMC 
      compliant in 2008, 30 attained compliance by 2011, and 61 were never compliant. 
      Share of prescriptions for heavily promoted antipsychotics was stable and 
      comparable between academic and nonacademic psychiatrists (63.0%-65.8% in 2008 
      and 62.7%-64.4% in 2011). Psychiatrists in AAMC-compliant centers were slightly 
      less likely to prescribe these antipsychotics compared with those in 
      never-compliant centers (relative odds ratio, 0.95; 95% CI, 0.94-0.97; P < 
      0.0001). Share of prescriptions for new/reformulated antipsychotics grew from 
      5.3% in 2008 to 11.1% in 2011. Psychiatrists in AAMC-compliant centers actually 
      increased prescribing of new/reformulated antipsychotics relative to those in 
      never-compliant centers (relative odds ratio, 1.39; 95% CI, 1.35-1.44; P < 
      0.0001), a relative increase of 1.1% in probability. CONCLUSIONS: Psychiatrists 
      exposed to strict conflict of interest policies prescribed heavily promoted 
      antipsychotics at rates similar to academic psychiatrists and nonacademic 
      psychiatrists exposed to less strict or no policies.
FAU - Anderson, Timothy S
AU  - Anderson TS
AD  - *Department of Internal Medicine, University of Pittsburgh Medical Center, 
      Pittsburgh, PA daggerDepartment of Health Care Policy, Harvard Medical School, Boston, 
      MA double daggerDepartment of Medicine, Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia, PA  section signDepartment of Health Policy and Management, Johns 
      Hopkins Bloomberg School of Public Health, Baltimore, MD  parallelDepartment of Health 
      Policy and Management, University of Pittsburgh Graduate School of Public Health, 
      Pittsburgh, PA  paragraph signMIT Sloan School of Management, Cambridge, MA #RAND Corporation, 
      Pittsburgh, PA **Department of Biostatistics, Harvard School of Public Health, 
      Boston, MA.
FAU - Huskamp, Haiden A
AU  - Huskamp HA
FAU - Epstein, Andrew J
AU  - Epstein AJ
FAU - Barry, Colleen L
AU  - Barry CL
FAU - Men, Aiju
AU  - Men A
FAU - Berndt, Ernst R
AU  - Berndt ER
FAU - Horvitz-Lennon, Marcela
AU  - Horvitz-Lennon M
FAU - Normand, Sharon-Lise
AU  - Normand SL
FAU - Donohue, Julie M
AU  - Donohue JM
LA  - eng
GR  - KL2 TR000146/TR/NCATS NIH HHS/United States
GR  - R01 MH093359/MH/NIMH NIH HHS/United States
GR  - R01MH093359/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Academic Medical Centers/*statistics & numerical data
MH  - Antipsychotic Agents/*administration & dosage/therapeutic use
MH  - *Conflict of Interest
MH  - Drug Utilization
MH  - Female
MH  - Humans
MH  - Male
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Psychiatry/*statistics & numerical data
PMC - PMC4360919
MID - NIHMS656811
EDAT- 2015/03/15 06:00
MHDA- 2015/05/27 06:00
PMCR- 2016/04/01
CRDT- 2015/03/14 06:00
PHST- 2015/03/14 06:00 [entrez]
PHST- 2015/03/15 06:00 [pubmed]
PHST- 2015/05/27 06:00 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - 00005650-201504000-00008 [pii]
AID - 10.1097/MLR.0000000000000329 [doi]
PST - ppublish
SO  - Med Care. 2015 Apr;53(4):338-45. doi: 10.1097/MLR.0000000000000329.