Prescriber profile and post-marketing surveillance

Area of Science:

• Pharmacovigilance
• Drug Safety Research
• Epidemiology

Background:

• The prescription-event monitoring (PEM) system faces declining response rates from general practitioners (GPs).
• Understanding factors influencing GP participation is crucial for effective post-marketing drug surveillance.

Purpose of the Study:

• To investigate the reasons behind falling response rates in the PEM system.
• To identify characteristics of general practitioners (GPs) associated with lower response rates for post-marketing drug data.

Main Methods:

• Analysis of prescribing patterns and GP characteristics for 27 drugs and 543,788 treatments in England (1984-1991).
• Categorization of 28,402 GPs into six groups based on prescribing volume.
• Examination of the relationship between prescriber demographics, prescribing volume, and response rates to data requests.

Main Results:

• A decrease in female GPs and an increase in overseas-qualified doctors were observed with higher prescribing volumes.
• The top 10% of prescribers accounted for 42% of total drug prescriptions.
• A consistent inverse relationship existed between prescribing volume and response rate; the heaviest prescribers had the lowest response rates (1% returned 34%).

Conclusions:

• Prescriber characteristics, such as being overseas-qualified and prescribing heavily, are linked to lower response rates in drug safety monitoring.
• Heavy prescribing by a minority of doctors may pose risks to patients and compromise the success of post-marketing drug surveillance.
• Interventions are needed to improve participation among high-volume prescribers to ensure robust drug safety data collection.