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Healthy Skepticism Library item: 41

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Jones MI, Greenfield SM, Bradley CP.
Prescribing new drugs: qualitative study of influences on consultants and general practitioners
BMJ 2001; 323:378-384
http://bmj.bmjjournals.com/cgi/content/full/323/7309/378

Keywords:
*analytic survey United Kingdom sales representatives primary care doctors source of information quality of prescribing internists (physicians) psychiatrists & psychiatry INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE PROMOTION AS A SOURCE OF INFORMATION: DOCTORS


Notes:

Objective
To explore consultants’ and general practitioners’ perceptions of the factors that influence their decisions to introduce new drugs into their clinical practice.

Design
Qualitative study using semistructured interviews. Monitoring of hospital and general practice prescribing data for eight new drugs.
Setting
Teaching hospital and nearby general hospital plus general practices in Birmingham.
Participants
38 consultants and 56 general practitioners who regularly referred to the teaching hospital.

Main outcome measures
Reasons for prescribing a new drug; sources of information used for new drugs; extent of contact between consultants and general practitioners; and amount of study drugs used in hospitals and by general practitioners.

Results
Consultants usually prescribed new drugs only in their specialty, used few new drugs, and used scientific evidence to inform their decisions. General practitioners generally prescribed more new drugs and for a wider range of conditions, but their approach varied considerably both between general and between drugs for the same general practitioner. Drug company representatives were an important source of information for general practitioners. Prescribing data were consistent with statements made by respondents.

Conclusions
The factors influencing the introduction of new drugs, particularly in primary care, are more multiple and complex than suggested by early theories of drug innovation. Early experience of using a new drug seems to strongly influence future use.

 

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What these howls of outrage and hurt amount to is that the medical profession is distressed to find its high opinion of itself not shared by writers of [prescription] drug advertising. It would be a great step forward if doctors stopped bemoaning this attack on their professional maturity and began recognizing how thoroughly justified it is.
- Pierre R. Garai (advertising executive) 1963