Awareness of Financial Conflicts of Interest in Selecting Clinical Practice Guidelines Among Nepalese Oncologists: A Cross-Sectional Study

Background

Financial conflicts of interest (FCOIs) between pharmaceutical companies and clinical practice guideline (CPG) authors can influence guideline recommendations, posing challenges to patient care. Despite global concerns, limited research exists on FCOI awareness among healthcare professionals in lower-middle-income countries like Nepal.

Methods

This cross-sectional study, conducted between June 2020 and January 2021, aimed to assess FCOI awareness among Nepalese oncologists and identify associated factors. Data were collected through an online survey of 102 oncologists selected from three medical societies. Descriptive statistics and Fisher's exact tests were used for analysis.

Results

Of the participants, 64 (63%) considered FCOIs between pharmaceutical companies and CPG authors when implementing guidelines. Significant associations were found between FCOI consideration and three factors: type of CPGs used, with higher consideration among users of national (80%) and international guidelines (69%) compared with local guidelines (44%) (p = 0.04); place of medical education, with higher consideration among Nepal-trained physicians (77%) compared with those trained abroad (61%) or both (44%) (p = 0.012); and experience in cancer field, with higher consideration among those with less than 10 years of experience (75%) compared with those having 10-20 years (49%) or more than 20 years (63%) of experience (p = 0.033).

Conclusion

While nearly two-thirds of Nepalese oncologists consider FCOIs when implementing CPGs, enhancing awareness among the remaining one-third is crucial. The findings suggest the need for targeted educational programs and stronger FCOI disclosure mechanisms, particularly as Nepal develops its own CPGs.