Relationship between the attitudes and reported behaviour of GPs and their prescribing costs
| Prescribing cost category | ||||
|---|---|---|---|---|
| Variable | Low | Medium | High | p value |
| The process of the consultation | ||||
| When faced with a patient who expects a prescription (which is not clinically indicated) my usual response is to (% discuss, but not prescribe) | 48.0% | 42.7% | 34.3% | <0.01 |
| When a new drug becomes available what I do most commonly is (% use the drug on a few patients and monitor) | 9.2% | 24.3% | 34.2% | <0.01 |
| When a new drug becomes available what I do most commonly is (% seek published findings of effectiveness) | 55.0% | 44.2% | 38.8% | <0.01 |
| I feel that a patient consultation that ends with me giving advice only is (% very satisfactory) | 38.9% | 38.3% | 31.8% | 0.07 |
| I find that writing a prescription can be a useful way of ending a consultation (% strongly agreeing or agreeing) | 49.9% | 52.9% | 56.0% | 0.15 |
| When I take a history from a patient I elicit their personal health beliefs about their illness (% always or usually) | 58.6% | 53.4% | 60.0% | 0.74 |
| Issuing a prescription may act as a cover for my lack of detailed knowledge (% strongly disagreeing or disagreeing) | 75% | 66.2% | 75.8% | 0.81 |
| Before prescribing I ask each patient about their “over the counter” medication (% always or usually) | 52.0% | 50.9% | 52.4% | 0.92 |
| Attitudes towards criticism of prescribing practices | ||||
| I find criticism of my prescribing habits by my colleagues (% very useful or useful) | 78.5% | 74.1% | 70.5% | 0.04 |
| There are opportunities for me to compare my prescribing habits with those of my partners (% very often or often) | 52.8% | 48.6% | 47.8% | 0.29 |
| I avoid questioning colleagues who appear to be prescribing inappropriately (% strongly disagreeing or disagreeing) | 51.5% | 50.2% | 46.1% | 0.22 |
| Sources of information about prescribed and over the counter medication | ||||
| My normal practice is to see drug reps in my surgery (% almost every day or at least once a week) | 28.7% | 41.8% | 55.5% | <0.01 |
| When I receive written promotional material from drug companies I usually (% never read it) | 29.8% | 25.0% | 17.3% | <0.01 |
| I find myself reading drug adverts in journals (% rarely or never) | 55.3% | 56.9% | 49.5% | 0.17 |
| When I prescribe, I compare the costs of different drugs which have the same effect (%very often or often) | 67.8% | 60.5% | 61.7% | 0.13 |
| When I am uncertain about an aspect of drug treatment, my first action, before I write the prescription is to: (% check in BNF) | 70.4% | 68.9% | 63.7% | 0.09 |
| Regular visits from a local retail pharmacist to advise me about prescribing issues would be helpful (% strongly agreeing or agreeing) | 31.7% | 40.7% | 33.1% | 0.72 |
| I follow the advice of hospital consultants in deciding which drugs to use for my patients (% very often or often) | 51.5% | 56.2% | 56.6% | 0.20 |
| My own prescribing costs are unnecessarily increased by hospital doctors, who prescribe expensive drugs for my patients (% strongly agreeing or agreeing) | 65.7% | 66.0% | 59.2% | 0.12 |
| I am happy that my knowledge of drugs that patients buy over the counter is up to date (% strongly agreeing or agreeing) | 35.3% | 38.0% | 38.0% | 0.50 |
| I receive helpful feed back from local retail pharmacists about the drugs that I am using for patients (% rarely or never) | 69.8% | 68.6% | 69.1% | 0.85 |
| Feelings of disorganisation | ||||
| In my practice, there are adequate mechanisms for reviewing patients’ needs for repeat prescriptions (% strongly agreeing or agreeing) | 80.2% | 74.8% | 72.6% | 0.05 |
| In what proportion of your consultations do you feel frustrated by having too little time (mean and 95% CI) | 37.8% (35.1 to 40.4) | 41.4% (38.5 to 44.2) | 43.8% (40.9 to 46.7) | <0.01 |