Factors influencing the choice of drug therapy in primary and secondary health care

Cossens, M.J., Davies, G., Bose, D. and Horne, R. (1995) Factors influencing the choice of drug therapy in primary and secondary health care. International Journal of Pharmacy Practice, 3 (4). pp. 213-218. 10.1111/j.2042-7174.1995.tb00821.x.

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DOI: 10.1111/j.2042-7174.1995.tb00821.x


A prescribing decision model incorporating drug characteristics, professional opinions and past experience was used to predict the choices made by prescribers when selecting a non-steroidal anti-inflammatory drug (NSAID) for inclusion in a formulary. Thirty general practitioners (GPs) and 14 hospital doctors (HDs), most practising within the South East Thames regional health authority, were asked to select either ibuprofen, diclofenac or indomethacin, based on the needs of a described population, and then to answer a questionnaire. Looking at the relative importance of factors influencing the choice of treatment, there was generally a high degree of agreement between HDs and GPs. However, the majority of HDs ranked efficacy as the most important drug characteristic whereas GPs were generally more concerned with side effects. Fundholding GPs ranked cost more highly than did their non-fundholding counterparts, and GPs working in single handed practices were more influenced by specialists and company representatives than were GPs working in groups. The decision model correctly predicted the drug choice of all the HDs and of 76 per cent of the GPs. These values were considerably better than the 33 per cent that would be predicted based on chance alone. Although various limitations of this type of study are noted, it is hoped that the model could be developed as a valuable tool to assist in understanding complex prescribing issues.

Item Type:Article
Departments, units and centres:Department of Practice and Policy > Centre for Behavioural Medicine
ID Code:2227
Journal or Publication Title:International Journal of Pharmacy Practice
Deposited By:Library Staff
Deposited On:17 Jun 2011 16:29
Last Modified:17 Jun 2011 16:29

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