Influences on prescribing in non-fundholding general practices

Area of Science:

• Health Services Research
• General Practice
• Pharmaceutical Policy

Background:

• Financial incentives, prescribing guidelines, and secondary care influence are known factors affecting general practice prescribing.
• General practice fundholding experience suggests financial incentives can impact prescribing behaviors.

Purpose of the Study:

• To assess general practitioners' attitudes towards a financial prescribing incentive scheme.
• To investigate the presence and utilization of prescribing guidelines.
• To determine the influence of secondary care-initiated prescribing on general practice.

Main Methods:

• A postal questionnaire survey was administered to non-fundholding general practices in the former Northern Region.
• The survey collected data on attitudes towards financial incentives, guideline use, and external prescribing influences.

Main Results:

• Internal practice discussions (45%) were the primary influence on decisions regarding the incentive scheme.
• Practices achieving savings were more positive about the scheme's achievability and timeline.
• Hospital prescribing significantly influenced prescribing for conditions like diabetes (57%) and ischemic heart disease (55%).
• While a minority reported using guidelines, their reported use was high when present.
• Over 50% of practices had clinical guidelines for asthma, diabetes, and hypertension.

Conclusions:

• General practitioner prescribing is shaped by a complex interplay of factors, with no single dominant influence.
• Further research is needed to align doctors' perceptions with actual prescribing practices regarding these influences.