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Australian dispensing doctors' prescribing: quantitative and qualitative analysis.
David Lim1, Jon D Emery, Janice Lewis
1School of Public Health, Curtin University, Perth, WA. david.limATcurtin.edu.au
The Medical Journal of Australia
|August 17, 2011
Summary
Australian dispensing doctors (DDs) prescribe fewer medications per patient compared to non-dispensing doctors. DDs
Area of Science:
- Health Services Research
- Pharmaceutical Policy
- General Practice
Background:
- Dispensing doctors (DDs) in Australia combine prescribing and dispensing roles.
- Previous international studies suggested potential for overprescribing by DDs.
- Understanding Australian DDs' prescribing patterns is crucial for pharmaceutical policy.
Purpose of the Study:
- To evaluate the prescribing practices of Australian dispensing doctors (DDs).
- To explore DDs' interpretations of their prescribing behaviors and findings.
- To compare prescribing patterns between DDs and non-DDs in Australia.
Main Methods:
- A sequential explanatory mixed-methods approach was used.
- Quantitative analysis of Pharmaceutical Benefits Scheme (PBS) claims data (2005-2007).
- Qualitative semi-structured interviews with DDs in rural and remote general practices (2009-2010).
Main Results:
- Dispensing doctors (DDs) issued fewer PBS prescriptions per 1000 patients (9452 vs 15057).
- DDs utilized Regulation 24 prescriptions more frequently than non-DDs (314 vs 67 per 1000 prescriptions).
- Interviews indicated peer prescribing norms and administrative workload influenced prescribing decisions.
Conclusions:
- Australian DDs did not demonstrate evidence of overprescribing.
- Prescribing practices of DDs were influenced by professional norms and practice efficiency.
- Findings contrast with some international research on dispensing doctors' prescribing.
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