B Ramasubbu1, M Heron2, R Ramasubbu3, P Murphy4. 1. Department of General Medicine, Midlands Regional Hospital, Tullamore, Ireland. ramasubb@tcd.ie. 2. Department of Anaesthesia, St George's Hospital, London, UK. 3. Department of Undergraduate Medicine, University of Edinburgh, Edinburgh, UK. 4. Department of General Medicine, Midlands Regional Hospital, Tullamore, Ireland.
Abstract
BACKGROUND: The Health Service Executive estimates it spent just under €2 billion on medicines in 2013 following a fivefold increase in the cost of medicines over the preceding decade. With this increasing cost, it is important to understand what factors affect doctors prescribing. AIMS: To investigate the influencing factors on prescribing of non-consultant hospital doctors (NCHDs) in Irish hospitals and to provide data regarding the sources of information NCHD's use for commonly prescribed drugs. METHODS: All medical manpower offices of adult public hospitals in the Republic of Ireland were emailed with our survey for distribution to NCHDs. It contained demographic information and questions regarding factors which most influence their prescribing of particular drug groups. Tests of significance were carried out using Chi-square. RESULTS: One hundred and seventy-nine surveys were returned out of a possible 8987 (0.02 %). Consultant preference was the biggest overall influencing factor on junior doctors prescribing (27 %). This was closely followed by local departmental policies (26 %). Evidence-based prescribing only influenced 14 % of the total prescribing of NCHDs with the pharmaceutical representative influence only a fraction behind (13 %). Knowledge obtained during medical school greater influenced postgraduate prescribing than undergraduate (34 vs 14 %, p = 0.046). Registrars were significantly more likely to prescribe using evidence-based medicine than intern and SHOs (p = 0.03). CONCLUSIONS: The prescription of medications in Ireland by NCHDs varies greatly depending not only on drug group, but it is also affected by the doctors' previous education and experience. This information is key in leading to sensible cost-effective prescribing.
BACKGROUND: The Health Service Executive estimates it spent just under €2 billion on medicines in 2013 following a fivefold increase in the cost of medicines over the preceding decade. With this increasing cost, it is important to understand what factors affect doctors prescribing. AIMS: To investigate the influencing factors on prescribing of non-consultant hospital doctors (NCHDs) in Irish hospitals and to provide data regarding the sources of information NCHD's use for commonly prescribed drugs. METHODS: All medical manpower offices of adult public hospitals in the Republic of Ireland were emailed with our survey for distribution to NCHDs. It contained demographic information and questions regarding factors which most influence their prescribing of particular drug groups. Tests of significance were carried out using Chi-square. RESULTS: One hundred and seventy-nine surveys were returned out of a possible 8987 (0.02 %). Consultant preference was the biggest overall influencing factor on junior doctors prescribing (27 %). This was closely followed by local departmental policies (26 %). Evidence-based prescribing only influenced 14 % of the total prescribing of NCHDs with the pharmaceutical representative influence only a fraction behind (13 %). Knowledge obtained during medical school greater influenced postgraduate prescribing than undergraduate (34 vs 14 %, p = 0.046). Registrars were significantly more likely to prescribe using evidence-based medicine than intern and SHOs (p = 0.03). CONCLUSIONS: The prescription of medications in Ireland by NCHDs varies greatly depending not only on drug group, but it is also affected by the doctors' previous education and experience. This information is key in leading to sensible cost-effective prescribing.
Authors: Brian P Lucas; Arthur T Evans; Brendan M Reilly; Yuri V Khodakov; Kalyani Perumal; Louis G Rohr; Joseph A Akamah; Tunji M Alausa; Christopher A Smith; Jeremy P Smith Journal: J Gen Intern Med Date: 2004-05 Impact factor: 5.128