Advanced

Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?-A multilevel logistic regression analysis in South Sweden.

Ohlsson, Henrik LU and Merlo, Juan LU (2009) In Pharmacoepidemiology and Drug Safety 18. p.682-690
Abstract
PURPOSE: Therapeutic traditions at health care practices (HCPs) influence physicians' adherence to prescription guidelines for specific drugs, however, it is not known if such traditions affect all kinds of prescriptions or only specific types of drug. Our goal was to determine whether adherence to prescription guidelines is a common trait of HCPs or dependent on drug type. METHODS: We fitted separate multi-level logistic regression models to all patients in the Skåne region who received a prescription for a statin drug (ATC: C10AA, n = 6232), an agent acting on the renin-angiotensin system (ATC: C09, n = 7222) or a proton pump inhibitor (ATC: A02BC, n = 11 563) at 198 HCPs from July 2006 to December 2006. RESULTS: There was a high... (More)
PURPOSE: Therapeutic traditions at health care practices (HCPs) influence physicians' adherence to prescription guidelines for specific drugs, however, it is not known if such traditions affect all kinds of prescriptions or only specific types of drug. Our goal was to determine whether adherence to prescription guidelines is a common trait of HCPs or dependent on drug type. METHODS: We fitted separate multi-level logistic regression models to all patients in the Skåne region who received a prescription for a statin drug (ATC: C10AA, n = 6232), an agent acting on the renin-angiotensin system (ATC: C09, n = 7222) or a proton pump inhibitor (ATC: A02BC, n = 11 563) at 198 HCPs from July 2006 to December 2006. RESULTS: There was a high clustering of adherence to prescription guidelines at HCPs for the different drug types (MOR(agents acting on the renin-angiotensin system) = 4.72 [95% CI: 3.90-5.92], MOR(Statins) = 2.71 [95% CI: 2.23-3.39] and MOR(Proton pump inhibitors) = 2.16 [95% CI: 1.95-2.45]). Compared with HCPs with low adherence to guidelines in two drug types, those HCPs with the highest level of adherence for these two drug types also showed a higher probability of adherence for the third drug type. CONCLUSION: Physicians' decisions to follow prescription guidelines seem to be influenced by therapeutic traditions at the HCP. Moreover, these therapeutic traditions seem to affect all kinds of prescriptions. This information can be used as basis for interventions to support rational and cost-effective medication use. Copyright (c) 2009 John Wiley & Sons, Ltd. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pharmacoepidemiology and Drug Safety
volume
18
pages
682 - 690
publisher
John Wiley & Sons
external identifiers
  • wos:000269009600005
  • pmid:19437457
  • scopus:70349773822
ISSN
1053-8569
DOI
10.1002/pds.1767
language
English
LU publication?
yes
id
574afe71-90c8-4cf6-89c4-bf574facc80a (old id 1412358)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19437457?dopt=Abstract
date added to LUP
2009-06-03 13:22:44
date last changed
2017-01-01 07:29:34
@article{574afe71-90c8-4cf6-89c4-bf574facc80a,
  abstract     = {PURPOSE: Therapeutic traditions at health care practices (HCPs) influence physicians' adherence to prescription guidelines for specific drugs, however, it is not known if such traditions affect all kinds of prescriptions or only specific types of drug. Our goal was to determine whether adherence to prescription guidelines is a common trait of HCPs or dependent on drug type. METHODS: We fitted separate multi-level logistic regression models to all patients in the Skåne region who received a prescription for a statin drug (ATC: C10AA, n = 6232), an agent acting on the renin-angiotensin system (ATC: C09, n = 7222) or a proton pump inhibitor (ATC: A02BC, n = 11 563) at 198 HCPs from July 2006 to December 2006. RESULTS: There was a high clustering of adherence to prescription guidelines at HCPs for the different drug types (MOR(agents acting on the renin-angiotensin system) = 4.72 [95% CI: 3.90-5.92], MOR(Statins) = 2.71 [95% CI: 2.23-3.39] and MOR(Proton pump inhibitors) = 2.16 [95% CI: 1.95-2.45]). Compared with HCPs with low adherence to guidelines in two drug types, those HCPs with the highest level of adherence for these two drug types also showed a higher probability of adherence for the third drug type. CONCLUSION: Physicians' decisions to follow prescription guidelines seem to be influenced by therapeutic traditions at the HCP. Moreover, these therapeutic traditions seem to affect all kinds of prescriptions. This information can be used as basis for interventions to support rational and cost-effective medication use. Copyright (c) 2009 John Wiley & Sons, Ltd.},
  author       = {Ohlsson, Henrik and Merlo, Juan},
  issn         = {1053-8569},
  language     = {eng},
  pages        = {682--690},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?-A multilevel logistic regression analysis in South Sweden.},
  url          = {http://dx.doi.org/10.1002/pds.1767},
  volume       = {18},
  year         = {2009},
}