Factors that Influence Prescribing Decisions

Schumock, Glen T.; Walton, Surrey M.; Park, Hayley Y; Nutescu, Edith A.; Blackburn, Juan C.; Finley, Jamie M; Lewis, Richard Kurt

doi:10.1345/aph.1d390

Cited by 96 publications

(91 citation statements)

References 22 publications

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“…Previous studies on how GPs choose between analogues have mostly been quantitative [4Á6]. In concordance with our study, two recent studies considered efficacy, formulary status, and policies restricting drug use to be highly influential in the decision to use one analogue instead of another [16,17].…”

Section: Strengths and Weaknesses Of The Studysupporting

confidence: 83%

Factors influencing GPs’ choice between drugs in a therapeutic drug group. A qualitative study

Buusman

Andersen

Merrild

et al. 2007

Scandinavian Journal of Primary Health Care

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Section: Strengths and Weaknesses Of The Studysupporting

confidence: 83%

Factors influencing GPs’ choice between drugs in a therapeutic drug group. A qualitative study

Buusman

Andersen

Merrild

et al. 2007

Scandinavian Journal of Primary Health Care

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“…Clinicians might also become reliant on an individual or specific class of medicine and, therefore prescribe by routine. It is well known that positive patient experiences with a specific medicine can reinforce prescribing practice (35,36). Exploring the reliance of prescribers on specific medicines and prescribing routines may enable identification of strategies to address this additional barrier to clinical practice guideline implementation.…”

Section: Future Directionsmentioning

confidence: 99%

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

Milder¹,

Lipworth²,

Williams³

et al. 2011

Arthritis Care & Research

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Objective: To explore the key motivators behind selection of analgesics (non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and complementary medications (CMs)) by patients with osteoarthritis (OA).Methods: A qualitative study, in which in-depth semi-structured interviews were conducted with 15 OA patients, recruited from four general practices in Sydney, Australia. Patients were aged 65 or above, and were currently taking, or had recently taken, an NSAID for osteoarthritis.Results: Three key themes emerged from the data: reliance, routine and pill load. Reliance: Patients were strongly reliant upon NSAIDs because they consistently satisfied their needs. By contrast, they were much less reliant upon paracetamol because of uncertainty or scepticism about its effectiveness. They were not reliant upon CMs but were willing to take them indefinitely because they were perceived as being without risk. Routine and pill load: Many patients took an NSAID, as well as CMs as part of a 'daily routine'. By contrast, patients had difficulty developing a routine around using paracetamol at the recommended maximum dose because of the implicit frequency of dosing required and an aversion to the associated 'pill load'. Conclusion:The results highlight the importance of exploring the perceptions and preferences of patients with regard to analgesics for OA. Clinician advice regarding analgesia for OA should take account of the possible reliance of the patient upon an NSAID, their medicine routines, and their potential concern about the pill load associated, in particular, with paracetamol.

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“…Although many factors besides cost influence physician prescribing habits, 19 research demonstrates that many physicians are unaware of drug pricing-overestimating inexpensive drugs and underestimating expensive ones. 20 However, physicians are receptive to using cost data to guide their prescribing, particularly to minimize patients' out-of-pocket costs.…”

Section: Discussionmentioning

confidence: 99%

Yelp for Prescribers: A Quasi-Experimental Study of Providing Antibiotic Cost Data and Prescription of High-Cost Antibiotics in an Academic and Tertiary Care Hospital

et al. 2015

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BACKGROUND: Physicians frequently prescribe antibiotics to inpatients without knowledge of medication cost. It is not well understood whether providing cost data would change prescribing behavior. OBJECTIVE: To evaluate the association between providing cost data alongside culture and antibiotic susceptibility results and prescribing of high-cost antibiotics. DESIGN: Quasi-experimental pre-post analysis. PARTICIPANTS: Inpatients diagnosed with bacteremia or urinary tract infection in two tertiary care hospitals. INTERVENTION: Cost category data for each antibiotic ($, $$, $$$, or $$$$) were added to culture and susceptibility testing results available to physicians. MAIN MEASURES: Average cost category of antibiotics prescribed to patients after the receipt of susceptibility testing results. KEY RESULTS: There was a significant decrease in the average cost category of antibiotics per patient after the intervention (pre-intervention = 1.9 $ vs. postintervention = 1.7 $, where 1.5 $ would mean that the average number of dollar signs for antibiotics prescribed was between $ and $$, p=0.002). After adjusting for age, insurance type, and prior length of stay, the odds ratio (OR) of a patient's average antibiotic being higher cost vs. lower cost after the intervention compared to before the intervention was 0.74 [95 % confidence interval (CI) 0.56, 0.98]. The intervention was associated with a 31.3 % reduction in the average cost per unit of antibiotics prescribed (p<0.001). CONCLUSIONS: Providing physicians with cost feedback alongside susceptibility testing data was associated with a significant decrease in prescription of high-cost antibiotics. This intervention is intuitive, low cost, and may shift providers toward lower cost medications when equally acceptable options are available.KEY WORDS: infectious disease; hospital medicine; health care costs, medical decision making.

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Factors that Influence Prescribing Decisions

Abstract: Those who seek to implement programs to alter medication use should recognize and employ factors that are most influential in the decision-making process. Further, it may be important to consider differences that exist between key participants in the medication use process.

Cited by 96 publications

References 22 publications

Factors influencing GPs’ choice between drugs in a therapeutic drug group. A qualitative study

Factors influencing GPs’ choice between drugs in a therapeutic drug group. A qualitative study

“It looks after me”: How older patients make decisions about analgesics for osteoarthritis

Yelp for Prescribers: A Quasi-Experimental Study of Providing Antibiotic Cost Data and Prescription of High-Cost Antibiotics in an Academic and Tertiary Care Hospital

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