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General practitioners' views on using a prescribing substitution application (ScriptSwitch(®))
1Academic Unit of Primary Care, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK. um08ch@leeds.ac.uk.
Informatics in Primary Care
|March 18, 2014
Summary
General practitioners (GPs) found the ScriptSwitch application acceptable for cost-effective prescribing but perceived its impact as limited. Enhancing the tool with more GP control could improve its success in managing drug costs.
Area of Science:
- Health Services Research
- General Practice
- Pharmacoeconomics
Background:
- General practitioners (GPs) face increasing pressure to prescribe cost-effectively due to rising expenditure and budget constraints.
- A computerised prescribing substitution application, ScriptSwitch®, offers cost-saving drug switch suggestions at the point of prescription.
- This application has been implemented by UK health commissioning organisations for medicines management.
Purpose of the Study:
- To explore general practitioners' (GPs) perspectives on utilizing a prescribing substitution application in their daily clinical practice.
- To understand the factors influencing GP engagement with computerised decision support for cost-effective prescribing.
Main Methods:
- A qualitative study design was employed, utilizing face-to-face semi-structured interviews.
- Eight general practitioners (GPs) from five practices in one North of England commissioning area participated.
- Interview data were audio-recorded, transcribed verbatim, and subjected to thematic analysis.
Main Results:
- Six key themes emerged: GP acceptance, application impact, external control, workflow disruption, GP willingness to switch, and patient willingness to switch.
- GPs generally accepted the application for promoting cost-effective prescribing but noted its limited impact alongside existing initiatives.
- A lack of application 'learning' and perceived tension between patient choice and prescribing priorities were significant findings.
Conclusions:
- Clinician, patient, and organisational factors influence engagement with prescribing substitution tools.
- While generally accepted, the application's effectiveness is constrained by its perceived limitations and the need to balance individual patient needs with population prescribing goals.
- Customisation of the application to local prescribing priorities and increased GP control may improve its successful adoption and impact.
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