Abstract
Background
The Health Service Executive estimates it spent just under €2 billion on medicines in 2013 following a fivefold increase in the cost of medicines over the preceding decade. With this increasing cost, it is important to understand what factors affect doctors prescribing.
Aims
To investigate the influencing factors on prescribing of non-consultant hospital doctors (NCHDs) in Irish hospitals and to provide data regarding the sources of information NCHD’s use for commonly prescribed drugs.
Methods
All medical manpower offices of adult public hospitals in the Republic of Ireland were emailed with our survey for distribution to NCHDs. It contained demographic information and questions regarding factors which most influence their prescribing of particular drug groups. Tests of significance were carried out using Chi-square.
Results
One hundred and seventy-nine surveys were returned out of a possible 8987 (0.02 %). Consultant preference was the biggest overall influencing factor on junior doctors prescribing (27 %). This was closely followed by local departmental policies (26 %). Evidence-based prescribing only influenced 14 % of the total prescribing of NCHDs with the pharmaceutical representative influence only a fraction behind (13 %). Knowledge obtained during medical school greater influenced postgraduate prescribing than undergraduate (34 vs 14 %, p = 0.046). Registrars were significantly more likely to prescribe using evidence-based medicine than intern and SHOs (p = 0.03).
Conclusions
The prescription of medications in Ireland by NCHDs varies greatly depending not only on drug group, but it is also affected by the doctors’ previous education and experience. This information is key in leading to sensible cost-effective prescribing.
Similar content being viewed by others
References
O’Leary et al (2015) Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland. BMC Res Notes 8:790. doi:10.1186/s13104-015-1764-x
OECD (2012) Education at a Glance 2012: OECD Indicators, OECD Publishing. http://dx.doi.org/10.1787/eag-2012-en
Irish Medical Council (2015) Medical Workforce Intelligence Report: a Report on the Annual Registration Retention Survey, 2014
Walshe et al (2006) Cost effectiveness of statin therapy for the primary prevention of coronary heart disease. Ir Med J 99(5):144–145
Davies J, Davies D (2010) Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 74(3):417–433. doi:10.1128/MMBR.00016-10
Hassali ML et al (2014) The experiences of implementing generic medicine policy in eight countries: a review and recommendations for a successful promotion of generic medicine use. Saudi Pharmaceutical Journal 22(6):491–503
Powis D, Hamilton J, Gordon J (2004) Are graduate entry programmes the answer to recruiting and selecting tomorrow’s doctors. Med Educ 38(1147–1153):4. doi:10.1111/j.1365-2929.2004.01986
Sefton AJ (2004) Graduate entry to medical school. Med Educ 38:1132–1134. doi:10.1111/j.1365-2929.2004.01983
Cahir et al (2012) Proton pump inhibitors: potential cost reductions by applying prescribing guidelines. BMC Health Services Research 12:408
Haas JS, Phillips KA, Gerstenberger EP, Seger AC (2005) Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997–2000. Ann Intern Med 142(11):891–897
McGowan B, Bennett K, Tilson L, Barry M (2005) Cost effective prescribing of proton pump inhibitors (PPI’s) in the GMS Scheme. Ir Med J 98(3):78–80
Richardson K, Moore PV, Peklar J, Galvin R, Bennett K, Kenny RA. (2012) Polypharmacy in adults over 50 in Ireland: Opportunities for Cost Saving and Improved Healthcare. The Irish Longitudinal Study on Ageing, Lincoln Place, Trinity College Dublin, Dublin 2, 2012
Lucas BP et al (2004) The impact of evidence on physicians’ inpatient treatment decisions. J Gen Intern Med 19(5 Pt 1):402–409
Lizner M (1987) The journal club and medical education: over one hundred years of unrecorded history. Postgrad Med J 63:475–478
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Funding
No funding was used in the production of this paper.
Rights and permissions
About this article
Cite this article
Ramasubbu, B., Heron, M., Ramasubbu, R. et al. A study to investigate the factors that influence the prescribing habits of non-consultant hospital doctors in Ireland. Ir J Med Sci 186, 363–367 (2017). https://doi.org/10.1007/s11845-016-1486-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-016-1486-7