A Survey on Patient's Perceptions of Risk and Related Factors for Generic Substitution

환자들의 대체조제에 대한 위험도 인식과 관련 요인

Background: The policy of separating prescription and dispensation of drug was implemented on July 1,2000 in Korea according to a revised pharmaceutical legislation and there have been considerable conflicts and confusions related with generic substitution under this new system. So this study was conducted to examine the patients' risk perceptions, attitudes, and behaviors for generic substitution and related factors with them. Methods : Subjects were 428 patients who visited two primary clinics, three secondary and one tertiary hospitals located in Seoul and Kyunggido. The subjects received self-administered questionnaire about risk perceptions, knowledges, attitudes, and behaviors for generic substitution. The perceived risk for generic substitution was measured using a 11-pointed differential scale(more than five, five and less than five points were categorized as high, mid and low in terms of risk perceptions for the generic substitution, respectively). Data were analysed for the related factors with risk perceptions and behaviors for generic substitution using Chi-square test and logistic regression analysis. Results : The percentages of subjects who perceived that generic substitution was riskier than dispensation as brand name drugs prescribed by physicians, and who had actually experienced generic substitution were 74.8%, and 38.3%, respectively. The attitudes and actual behaviors for generic substitutions were significantly associated with risk perception for the generic substitution(P<0.05). The adjusted Odd's ratio of risk perceptions for the generic substitution as a function of age, patients using primary clinic and patients with chronic disease was 0.969(95% CI, 0.943-0.996), 1.958(95% CI, 1.082-3.546) and 2.296(95% CI, 1.090-4.115), respectively ( P<0.05). Conclusion : This study suggested that patients' risk perceptions be related with attitudes and behaviors for generic substitution and some medical factors may affect the risk perception for generic substitution. So physicians are encouraged to discuss the risk and safety of generic substitution with patients. Especially, physicians need to pay much attention to the patients with chronic diseases because they have been shown to perceive generic substitution to be safe blindly.