Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
Res Social Adm Pharm. 2013 Nov-Dec;9(6):981-8. doi: 10.1016/j.sapharm.2012.10.006. Epub 2012 Dec 5.
Prescribing decisions are a complex phenomenon and influenced by many pharmacological and non-pharmacological factors. Little is known about the actual prescribing behaviors of physicians or the factors behind their prescribing decisions.
The objective of this study was to explore the factors that influence physicians' prescribing decisions and the role of the marketing activities by pharmaceutical companies in this decision-making process.
A semi-structured interview with the critical incident technique method was used to encourage physicians to describe the particular situations of prescribing for specific newly marketed drugs. All interviews were transcribed verbatim and thematic content analysis with systematic and comprehensive coding was employed to identify categories of physicians' reasons for either prescribing or not of the study drugs.
Factors that influence prescribing of the study drugs (223 critical incidents) were categorized in six major themes. Drug characteristics, the most frequently mentioned by physicians as reasons of prescribe, were implicated in 70 (31.4%) incidents, followed by pharmaceutical company mentioned in 53 (23.8%) incidents, indications, 31 (13.9%) incidents, and patient contexts, 26 (11.7%) incidents. Environmental factors as information and evidence were implicated in 22 (9.9%) incidents, and physician factor, 21 (9.4%) incidents.
Prescribing is a complex process and physicians integrate different factors. Although physicians make a considerable on patient contexts and treatment outcomes, they still rely on their personal experiences when making prescribing in addition to firms' source of information and firms' marketing activities.
处方决策是一种复杂的现象,受到许多药理学和非药理学因素的影响。对于医生的实际处方行为以及他们处方决策背后的因素知之甚少。
本研究旨在探讨影响医生处方决策的因素以及制药公司营销活动在这一决策过程中的作用。
采用半结构式访谈和关键事件技术方法,鼓励医生描述为特定新上市药物开处方的特定情况。对所有访谈进行逐字转录,并采用系统全面的编码进行主题内容分析,以确定医生开处方或不开处方研究药物的原因类别。
影响研究药物处方的因素(223 个关键事件)分为六个主要主题。药物特性是医生最常提及的处方原因,有 70 个(31.4%)事件涉及,其次是制药公司,有 53 个(23.8%)事件涉及,适应症有 31 个(13.9%)事件涉及,患者情况有 26 个(11.7%)事件涉及。环境因素作为信息和证据,有 22 个(9.9%)事件涉及,医生因素有 21 个(9.4%)事件涉及。
处方是一个复杂的过程,医生整合了不同的因素。尽管医生在考虑患者情况和治疗效果方面做了大量工作,但他们在做出处方决策时除了依赖公司的信息来源和公司的营销活动外,仍然依赖个人经验。