Decision making and prescribing patterns--a literature review

Area of Science:

• Pharmacology
• Health Services Research
• Medical Decision Making

Background:

• Prescribing patterns vary significantly among doctors.
• Previous research focused on doctor characteristics and correlates of good prescribing, with limited success.
• Understanding the decision-making processes underlying prescribing is crucial for further insights.

Purpose of the Study:

• To review the literature on variations in prescribing patterns.
• To critically evaluate attempts to link prescribing variation to doctor characteristics.
• To explore the decision-making processes involved in prescribing, including drug adoption, selection, and treatment decisions.

Main Methods:

• Literature review of studies on prescribing patterns and their correlates.
• Analysis of research on drug adoption and relinquishment (1966-1991).
• Examination of literature on drug selection within individual consultations and the 'drug choice model'.
• Review of studies on the decision to treat, noting empirical gaps.

Main Results:

• Efforts to correlate prescribing variation with doctor characteristics have limitations.
• Understanding underlying decision-making processes is key to analyzing prescribing behavior.
• Evidence for specific models like the 'drug choice model' in individual consultations is assessed.
• There is a notable lack of empirical evidence regarding the decision to treat.

Conclusions:

• Further research into the decision-making processes of doctors is needed to understand prescribing behavior.
• The review highlights the complexity of prescribing and the need for nuanced analytical approaches.
• Identifying gaps in empirical evidence, particularly concerning the decision to treat, is essential for future research directions.