Changing medication: general practitioner and patient perspectives

Abstract

Abstract This study, carried out in one fundholding general practice with 9,680 patients, assessed the acceptability to patients and general practitioners of three types of prescribing changes to repeat medication: generic substitution, therapeutic substitution, and changing delivery device. Patients' opinions were sought via a postal questionnaire, face-to-face semi-structured interviews and telephone interviews. Prescribers' views were sought via face-to-face interviews with five GPs and an asthma clinic doctor. The interviews assessed the acceptability of the changes to the patients, and the attitudes of prescribers towards identifying the need for change and carrying it out. Of 78 patients who returned the postal questionnaire following a change from branded to generic medicine, 14 (18 per cent) were “happy” with the change, 48 (62 per cent) were “not bothered” and 12 (15 per cent) were “unhappy” (four did not answer the question). Of 25 patients, interviewed face-to-face, whose prescription for ranitidine had been changed to cimetidine, 21 (84 per cent) were not concerned about the change. Of 15 patients, interviewed by telephone, who were asked to change their asthma delivery device, eight had refused to be changed, one had reverted back and the remaining six were happy with their new delivery device. Interviews with the prescribers showed that they had expected a higher level of resistance and complaints from patients than had proved to be the case. Simple changes to patients' repeat medication are feasible and have a high level of acceptance provided the proposed change is appropriately communicated to the patient.