Factors associated with antipsychotic drug prescribing by southern psychiatrists

The relative influence of physician, patient, and treatment setting characteristics on antipsychotic drug prescribing are examined using survey data collected in 1979 employing a sample of 61 North Carolina psychiatrists and 1003 of their patients. Antipsychotic drug prescribing is conceptualized as a three-stage, sequential decision-making process, beginning with the clinician's decision to prescribe any psychopharmaceutical, moving on to the decision to prescribe an antipsychotic agent, and finally to the determination of antipsychotic drug dosage. Regression analyses utilizing each of these three decision points as a dependent variable indicates that patient characteristics, particularly those clinically associated with the patient's mental illness, are the major determinants of psychiatrists' drug prescribing. In addition, a number of "clinically suspect" patient characteristics (race, occupation, and marital status) are found to be significant during certain stages of the prescription process. Despite the influence of these suspect patient variables, study findings in general suggest that antipsychotic medication is prescribed in a clinically appropriate manner.