Drug prescription attitudes and behaviour of general practitioners. Effects of a problem-oriented educational programme.

A producer-independent, problem-oriented, group-education programme with 2-day meetings on drug treatment in primary health care (PHC) was developed and evaluated. Initially, it was tested on a selected group of general practitioners (district physicians), using a non-exposed group as control. A comprehensive questionnaire was used to test changes in attitudes. There was a significant change in attitudes concerning both general opinions on drugs and drug use, on information about drug treatment, and on use of drugs in selected therapeutic areas. Also, the district physicians became more critical towards information from pharmaceutical companies. Prescribing patterns tended to change in accordance with the attitude changes. Subsequently, the programme was offered to all district physicians (about 550) in the southern Swedish health care region for a 10-year period, with 20-25 district physicians per 2-day meeting. The impact of the programme on the prescribing of a selected group of drugs (antibiotics) was assessed by voluntary registration of prescription by the participants, by regional prescription analyses and by analyses of drug sales data. There were significant, consistent, and sustained changes in the prescribing of antibiotics. The study supports the view that, if drug prescribing in general practice is to be improved, producer-independent, problem-oriented, face-to-face, small-group education on drug treatment is worthwhile.