The social science contribution to pharmacoepidemiology

An understanding of the inappropriate use of pharmaceuticals (the prescribing of unnecessary or ineffective medications, and non-compliance by consumers) can be furthered by considering the psychological, social and cultural contexts in which medicines are used. The consumers are influenced by their beliefs about benefits, safety and cost; opinions of their social group; and emotions associated with taking the medication itself. Similar considerations apply to the prescribers or dispensers of the drugs, who are also influenced by the marketing and regulatory practices of their countries. A model of drug use which takes these factors into account can suggest various strategies to increase optimal pharmaceutical utilization. To date, these efforts have focused almost exclusively on the prescriber or manufacturer, and have had limited success. However, other, more effective techniques exist, which can modify the behavior of both of these groups, and of the consumers. A strategy of research in this area is outlined.