Prescribing variation across Europe: Insights into prescribing practices and educational needs

Area of Science:

• Medical Education
• Pharmacology
• Healthcare Professional Training

Background:

• Prescribing medication is complex, influenced by diverse factors.
• Four prescriber profiles exist: pragmatic-contextual, guideline-oriented, experience-driven, and vulnerability-focused.
• The prevalence of these profiles among European prescribers and their integration into education remain unclear.

Purpose of the Study:

• To assess European prescribers' identification with four distinct profiles.
• To evaluate the coverage of these profiles in clinical pharmacology and therapeutics (CPT) education.
• To inform improvements in prescribing education and practice.

Main Methods:

• A cross-sectional survey was distributed to physicians, physician assistants, advanced nurse practitioners, and prescribing pharmacists across Europe.
• Participants ranked their identification with the four prescriber profiles.
• They also indicated recognition of these profiles in colleagues and their coverage in CPT education.

Main Results:

• 170 prescribers from 23 European countries participated.
• Most identified as pragmatic-contextual (36.5%) or guideline-oriented (42.9%).
• Experience-driven (11.2%) and vulnerability-focused (9.4%) profiles were less common self-identifications. Pragmatic-contextual and guideline-oriented prescribing were covered in CPT education, while vulnerability-focused prescribing was poorly represented.

Conclusions:

• Professional background, clinical setting, and experience significantly influence prescribing approaches in Europe.
• Current CPT curricula align with the prevalence of pragmatic-contextual and guideline-oriented profiles.
• Experience-based and vulnerability-focused profiles, though observed in practice, require greater emphasis in educational strategies to enhance prescribing practice.