Introduction: The interaction between physicians and pharmaceutical industry highlighted many issues lately concerning their influence on physician's attitude and their prescribing behavior.

Aim: To evaluate the attitudes of Tunisian ophthalmologist towards pharmaceutical promotion.

Methods: Data was collected through an auto-administered anonymous questionnaire elaborated in French that was distributed to 160 ophthalmologists (residents and specialists) working in hospitals or private practices in four Tunisian governorates (Tunis, Sousse, Monastir and Sfax).

Results: One hundred and two valid responses were received. Twenty-nine respondents (28.43%) estimated the number of visits by pharmaceutical representatives (PR) at 11 to 20 times during the last year. Most physicians considered guides (94%), drug samples (88%), articles (86%), stationery (81%), sponsorship of overseas conferences (72%) and international trips to symposia organized by pharmaceutical industries (58%), as appropriate gifts. Over 80% of doctors agreed that promotional activities by drug companies were appropriate. Accepting sponsorship from a pharmaceutical company for a partner to attend a meeting was considered inappropriate by 79% of ophthalmologists. Eighty-eight percent of the respondents agreed that receiving gifts will increase their prescription of the company's drug. However, they perceived themselves to be less influenced than their colleagues (p=0.011). Eighty-six percent of ophthalmologists reported training about how to interact with PR to be insufficient.

Conclusions: Despite the role of PR in supporting research, ethical issues may arise through their interactions with healthcare professionals. Training about pharmaceutical promotion and appropriate ways to deal with it are lacking in Tunisian medical schools' curricula, leaving future doctors unprepared to deal with pharmaceutical influences.

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