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How physicians choose drugs.

P Denig¹, F M Haaijer-Ruskamp, D H Zijsling

¹Department of Pharmacology & Clinical Pharmacology, University of Groningen, The Netherlands.

Social Science & Medicine (1982)

|January 1, 1988

Summary

Physician drug choices for irritable bowel syndrome (IBS) and renal colic are influenced by attitudes, norms, and experiences, not patient demand. Efficacy expectations and professional environment significantly impact prescribing behavior.

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Area of Science:

Pharmacoeconomics
Health Psychology
Medical Decision Making

Background:

Physician prescribing behavior is complex, influenced by multiple factors beyond clinical efficacy.
Understanding these factors is crucial for effective drug promotion and education.

Purpose of the Study:

To test a drug choice model incorporating physician attitudes, norms, and personal experiences.
To analyze the determinants of drug selection for irritable bowel syndrome (IBS) and renal colic.

Main Methods:

A survey of 169 physicians estimating model components for IBS and renal colic treatments.
Physicians rated expectancies and values for treatment outcomes, professional acceptability, patient demand, and personal experience with three drugs for each condition.

Main Results:

Patient demand had a negligible influence on drug choice.
The model predicted drug choice in 74% (IBS) and 78% (renal colic) of cases, but only renal colic choices were fully reasoned.
Efficacy expectations and professional environment were key drivers, more so than side effect expectations or patient demand.

Conclusions:

Physician drug preferences are primarily driven by efficacy expectations and professional norms, not patient demand.
Interventions to change prescribing behavior should focus on influencing these factors, potentially through group educational programs rather than individual technical information.

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