***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Generic Medicines are an important policy option allowing for access to affordable , essential medicines . Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities . Existing negative perceptions surrounding the quality of generic medicines must be addressed to ensure that people use them with confidence . Campaigns to increase the uptake of generic medicines by consumers and providers of healthcare need to be informed by local norms and practice s. This study sought to compare South African consumers ’ and healthcare providers ’ perceptions of quality of generics to the actual quality of selected products . Methods The study was conducted at the local level in three cities of South Africa : Johannesburg , Durban and Cape Town . Purposive sampling was used to recruit consumer participants ( n = 73 ) and r and om sampling used to recruit healthcare providers from public and private sectors ( n = 15 ) . Data were obtained through twelve focus group discussion s with consumers and semi-structured interviews ( n = 15 ) with healthcare providers in order to gain familiarity with perceptions of quality . One hundred and thirty five products comprising paracetamol tablets ( n = 47 ) , amoxicillin capsules ( n = 45 ) and hydrochlorothiazide tablets ( n = 43 ) were source d from public and private sector healthcare providers . These products were subjected to in vitro dissolution , uniformity of weight and identity ( Fourier Transformed Infrared Spectroscopy ) tests using prescribed methods from the British ( 2005 ) and United States Pharmacopeias ( 2006 ) . Results Respondents described drug quality in relation to the effect on symptoms . Procurement and use behavior of healthcare providers was influenced by prior experience , manufacturers ’ names and consumers ’ ability to pay . All formulations passed the in vitro tests for quality . Conclusions This study showed clear differences between perceptions of quality and actual quality of medicines suggesting deficiencies in public engagement by government regarding the implementation of generic medicines policy . Implementation of generic medicines policy requires the involvement of consumers and healthcare providers to specifically address their information gaps and needs The use of generic drugs has increased significantly in recent years . Since generic drugs are available at a lower cost , they provide an opportunity for savings in drug expenditure . Thus , use of generic drugs is encouraged especially in developing countries . There are only a few studies concerning the perceptions and attitudes of the healthcare providers and patients towards generic drug use . Methods The present study was conducted by a face to face question naire in the Kadikoy district of Istanbul in April 2010 . From r and omly chosen respondents , 68 pharmacists , 56 prescribers and 101 patients consented to participate in the study . Results Thirty one and 32 % of the pharmacists and prescribers , respectively , expressed that they believed that the generics did not differ from the original drugs , whereas only 24 % of the patients believed so . Forty percent of the pharmacists and 82 % of the prescribers told that they were unsure about the bioequivalence of the generics . Ten percent of the patients cl aim ed that they immediately accept generic substitution  by the pharmacist , while 26 % accepted it if it was substituted by the prescriber . Cost was the most important factor taken into consideration about generic substitution ( 92 % for prescribers ; 83 % for patients and 82 % for pharmacists ) . Conclusions Our findings demonstrated that healthcare providers as well as the drug consumers have insufficient knowledge about generic drugs . Therefore , they should be better educated with respect to generic substitution Background Generic substitution has been implemented in many countries , but knowledge about patients ’ attitudes , beliefs and experiences is still sparse . Aim To assess associations between generic switching and patients ’ attitudes , beliefs and experiences with previous generic switching . Design and setting A cross-sectional study comprising question naire responses from 2,476 r and omly selected patients aged 20 years or older and living in the Region of Southern Denmark , who had redeemed substitutable drugs . Methods The question naire included items on  beliefs about medicine , views on generic medicine and confidence in the healthcare system . Only prescriptions issued by the general practitioners were included . For each patient , we focused on one purchase of a generically substitutable drug ( index drug ) . Patients were identified by means of a dispensing data base . Results Earlier generic switches within the index ATC code were statistically significantly associated with experience of a generic switch ( adjusted OR 5.93 ; 95 % CI 4.70–7.49 ) . Having had more than five earlier switches within other ATC codes and having negative views on generic medicines reduced the odds of experiencing a generic switch . No associations were found between generic substitution and gender , drug group , number of different drugs used by the patient , confidence in the health care system and beliefs about medicine in general . Conclusion Patients who had once experienced a generic switch were more likely to accept a future generic switch within the same ATC code . Negative views on generic medicines were negatively associated with switching , while beliefs about medicine and confidence in the healthcare system had no influence This survey examined current patient awareness and underst and ing of generic substitution . We surveyed 188 renal patients using 36 multiple-choice questions in 2 hospitals in the United Arab Emirates . We found that 70 % of patients were aware of the availability of  generic medicines , 60 % understood the terms " generic " and " br and ed " in relation to medicines and 64 % were conscious of generic substitution practice . However , 32 % did not know if they were taking generics and 31 % felt that generics were not equivalent or only sometimes equivalent to br and ed medicines . Nearly half ( 47 % ) the patients stated they would refuse generic substitution of ciclosporin when it became available if this was just to save the health authority money . In our opinion , r and om generic substitution should not be implemented because there is still uncertainty and lack of knowledge among patients Objective The aim of the study was to assess patients ’  attitudes towards and experiences of generic substitution  3 years after generic substitution of prescription medicines was permitted in Norway . Methods Prescriptions from 2,128 consecutive patients in a Norwegian pharmacy were retrospectively review ed to identify all patients ( n = 274 ) receiving eight or more different prescription drugs on the fifth level in the Anatomical Therapeutic Chemical ( ATC ) classification system during the last 6 months . An age-adjusted control group ( n = 269 ) of patients receiving three to seven different prescription drugs  was r and omly selected . Of the 543 patients , 386 were eligible for inclusion . Both groups received a mailed question naire addressing their experiences with and attitudes towards generic substitution . Results The overall response rate was 73 % ( 281/386 ) and the average age of the respondents was 66 years old . The study found that patients who reported to have received information from their physician or the pharmacy about generic substitution were more likely to have switched ( P < 0.001 ) . About half ( 138/281 ) of the patients had experienced a generic switch , and a higher proportion of the polypharmacy patients had their medication substituted compared to the control patients ( P < 0.001 ) . Altogether 50 ( 36 % ) of the patients who had experienced a switch , reported one or more negative experiences connected to the substitution , and 29 of these ( 21 % ) reported an overall negative experience after the change . The experiences of the patients were not related to age , gender , or number of medications or information about generics from either the pharmacy or the physician . About 41 % of the patients would not switch if they had no personal economic incentives . Conclusions About 1/3 of the patients who had their medication substituted reported negative experiences . Generic drug substitution for a number of patients is not considered an equal alternative to br and ed drugs , and these patients may need additional information and support . The lack of correlation between patient experiences and age , gender , and medical regimen complexity is interesting and should be investigated further PURPOSE This study aims to investigate the possible association between patients ' concerns about their medicine and generic switch . METHODS Cross-sectional survey was carried out comprising responses from 2217 r and omly selected persons aged 20 years or older and living in the Region of Southern Denmark , who had redeemed generically substitutable drugs in September 2008 . For each patient , we focused on the purchase of one generically substitutable drug ( index drug ) . We applied the specific concerns subscale from the Beliefs about Medicine Question naire ( BMQ ) to analyse lack of confidence in treatment . We also included  general beliefs about medicine ( BMQ ) , views on generic medicine and confidence in the health-care system . The information about the patients ' generic switch was obtained from a prescription data base and not provided by the patients . Data were analysed using linear regression . RESULTS No statistically significant associations were found between concerns about the index medicine and the generic switch ( -0.02 95 % CI : -0.10 ; 0.05 ) . Viewing medicines as harmful in general was associated with increased concerns ( BMQ general harm : 0.39 95 % CI : 0.30 ; 0.47 and BMQ general overuse : 0.28 95 % CI : 0.20 ; 0.35 ) . Patients having high confidence in the health-care system showed less concern ( -0.16 95 % CI : -0.27 ; -0.06 ) . CONCLUSION This study showed that for all three drug categories investigated , the patients who experienced a generic switch did not have more concerns about their index medicine than patients who did not switch Background : Insurers and policymakers strive to stimulate more cost-effective prescribing and , increasingly , are educating beneficiaries about generics . Objectives : To evaluate the relationship between patient beliefs and communication about generic drugs and actual drug use . Research Design and Subjects : We performed a national mailed survey of a r and om sample of 2500 commercially-insured adults . Patient responses were linked to pharmacy cl aims data to assess actual generic medication use . Measures : We used factor analysis to develop 5 multi-item scales from patient survey responses that measured : ( 1 ) general preferences for generics , ( 2 ) generic safety/effectiveness , ( 3 ) generic cost/value , ( 4 ) comfort with generic substitution , and ( 5 ) communication with providers about generics . The relationship between each scale and the proportion of prescriptions filled for generics was assessed using linear regression , controlling for demographic , health , and insurance characteristics . Separate models were created for each scale and then all 5 scales were included simultaneously in a fully-adjusted model . Results : The usable response rate was 48 % . When evaluated independently , a 1 SD increase in each of the 5 scales was associated with a 3.1 % to 6.3 % increase in generic drug use ( P < 0.05 for each ) . In the fully adjusted model , only 2 scales were significantly associated with generic drug use : comfort with generic substitution ( P = 0.021 ) and communication with providers about generic drugs ( P = 0.012 ) . Conclusions : Generic drug use is most closely associated with the 2 actionable items we evaluated : communication with providers about generics and comfort with generic substitution . Educational campaigns that focus on these 2 domains may be most effective at influencing generic drug use OBJECTIVES This study evaluated Australian community pharmacists ' rate of  generic medicine substitution , patient acceptance of generic substitution and cost-savings achieved for patients from substitution . METHOD A national stratified sample of 500 Australian pharmacies was r and omly selected from different geographical areas . The data of the first 25 original PBS prescription items dispensed on one working day eligible for generic substitution were collected from each pharmacy . RESULTS Responses were received from 82 pharmacies with a response rate of 16.4 % . The pharmacists recommended generics for 96.4 % ( 1461/1515 ) of the prescription items which were eligible for substitution . The generic substitution recommendation rate in urban ( 98.7 % ) and rural areas ( 98.0 % ) was significantly higher than remote areas ( 91.6 % ) . Conversely , patients ' acceptance in remote areas ( 84.5 % ) was significantly higher than rural ( 78.6 % ) and urban areas ( 73.2 % ) . Patients with chronic diseases demonstrated significantly lower acceptability ( 72.4 % ) than patients with acute conditions ( 81.6 % ) . Through acceptance of substitution , the patients ' medicines expenditure reduced by around 21 % . CONCLUSION Australian community pharmacists demonstrated a high rate of recommending generic substitution . However , to optimize the generic medicines utilization , patients ' acceptance requires further improvement Objectives The aim of this project was to evaluate the perceptions , knowledge and attitudes regarding generic medicines . Methods A cross-sectional study , with self administered question naires , was conducted to survey consumers visiting pharmacies in four regions of Auckl and ( North Shore , Waitakere , Central Auckl and and South Auckl and ) . Through stratified r and om sampling , approximately 10 % of pharmacies from each region were selected , which turn out to be 30 pharmacies . Every alternate customer coming to the pharmacy , who was eligible to participate in the study , was asked by the research ers to complete the question naire . Results A total of 441 question naires were included in the analysis . Different response rates were obtained in different regions of Auckl and . Of all respondents , 51.6 % had previous knowledge of generic medicines .  Pharmacists were the main source of information regarding generic medicines followed by doctors and media . A higher level of education had a direct relationship with having correct knowledge of generics ( P = .002 ) . Attitude of participants toward the use of generic medicines  was determined by their knowledge of generics , whether it was recommended by a pharmacist and their type of illness . Participants were more prepared to change to a generic for a minor illness ( 79 % ) than for a major illness ( 58.7 % ) . Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness ( P = .001 ) as well as minor illness ( P < .0001 ) . Previous positive experiences with generics also determined consumers ’ willingness to use generics . Conclusion Many consumers have 
    Output:
    
Familiarity and trust in br and names appears to be a substantial barrier to the increased use of generics , with patients also appearing to hold the view that if a product is cheaper , then it must not be as good .
Some publications report positive views of generics , with positively inclined consumers stating that they did not perceive any difference between a generic and the proprietary medicine .
Acceptance of generics appears to be higher in consumers with higher levels of education while patients from lower socioeconomic demographic groups tend to have greater mistrust of generics .
Conclusions The provision of information to consumers that dispels myths about generics may improve confidence in generic medicines .
As patients demonstrate a high degree of trust in physicians , their opinions can impact on patient/consumer opinions .
Therefore , enhancing the perceptions of generics held by physicians is likely to have a positive impact on patient/consumer opinions of , and trust in , generic medications