OBJECTIVE: Iatrogenic, environmental and economic consequences of drug prescription are public health issues. This study was designed to identify physician, patient and consultation characteristics that influence drug prescription in general practice. METHODS: A national multicentre cross-sectional study was conducted in general practice from December 2011 to Apri/2012. Bivariate analyses were performed, followed by multivariate analyses based on a mixed model. RESULTS: At least one drug was prescribed in 16,626 (80.7%) of 20,600 consultations conducted by 128 practitioner. Apart from the number of health problems managed (OR= 10.6 [8.8; 13.0] if :2 4), independent patient-related factors were female gender (OR= 1.1 [1.0; 1.2]), extreme ages (OR= 1.3 [1.1; 1.5]younger than 4 years, OR= 1.5 [1.3; 1.8] from 5 to 14 years, and OR= 1.3 {1.2; 1.5] older than 60 years vs. between 15 to 29 years), new patients (OR= 0.8 {0. 7; 0.9]), work accident or occupational disease (OR= 0.3 {0.3; 0.4]). For the physician, drug prescription was linked to visits by pharmaceutical representatives (OR = 1.6 [1.2; 2.0] if :2 5 times a week) but not to visits by Public Health Insurance delegates or signature of the contract designed to improve individual practices (CAP/). CONCLUSIONS: Independently of health problems, patient and physician characteristics, including visits by pharmaceutical representatives, influence drug prescription.
OBJECTIVE: Iatrogenic, environmental and economic consequences of drug prescription are public health issues. This study was designed to identify physician, patient and consultation characteristics that influence drug prescription in general practice. METHODS: A national multicentre cross-sectional study was conducted in general practice from December 2011 to Apri/2012. Bivariate analyses were performed, followed by multivariate analyses based on a mixed model. RESULTS: At least one drug was prescribed in 16,626 (80.7%) of 20,600 consultations conducted by 128 practitioner. Apart from the number of health problems managed (OR= 10.6 [8.8; 13.0] if :2 4), independent patient-related factors were female gender (OR= 1.1 [1.0; 1.2]), extreme ages (OR= 1.3 [1.1; 1.5]younger than 4 years, OR= 1.5 [1.3; 1.8] from 5 to 14 years, and OR= 1.3 {1.2; 1.5] older than 60 years vs. between 15 to 29 years), new patients (OR= 0.8 {0. 7; 0.9]), work accident or occupational disease (OR= 0.3 {0.3; 0.4]). For the physician, drug prescription was linked to visits by pharmaceutical representatives (OR = 1.6 [1.2; 2.0] if :2 5 times a week) but not to visits by Public Health Insurance delegates or signature of the contract designed to improve individual practices (CAP/). CONCLUSIONS: Independently of health problems, patient and physician characteristics, including visits by pharmaceutical representatives, influence drug prescription.
Authors: Bruno Goupil; Frédéric Balusson; Florian Naudet; Maxime Esvan; Benjamin Bastian; Anthony Chapron; Pierre Frouard Journal: BMJ Date: 2019-11-05
Authors: Louise Devillers; Jonathan Sicsic; Angelique Delbarre; Josselin Le Bel; Emilie Ferrat; Olivier Saint Lary Journal: PLoS One Date: 2018-01-25 Impact factor: 3.240