Factors Influencing Drug Prescribing — Inquiry into Research Strategy

Abstract

This review analyzes the approaches used in published studies into doctors' prescribing habits. Sixty-four studies in English, Scandinavian languages, and Finnish, mainly from the last 15 years, are included. Some factors affecting prescribing have not been studied and there were very few studies into two potentially important factors, education and control measures. Studies which measured the effect of drug firms tend to concentrate on the conventional forms of advertising. The general limitations of each of the approaches are listed and those which seem unlikely to yield much new information are pointed out. Some novel approaches are proposed. covering the last 15 years were searched systematically, but journals in other fields were not covered so systematically. Some earlier studies were also included. Some studies of possible importance were unobtainable. Only those studies were included in which the objective was to determine which factors affect, or to what extent they affect, drug prescribing. Studies designed to determine physicians' opinions on the different sources of drug information were. also included. The latter, in some studies, enlarged upon their initial objective. Articles which included descriptions of drug-firms were excluded if the authors had not connected them to drug prescribing. Studies which described prescribing as such were not included. Only studies into “non-medical” factors were included. Studies into the effects of the results of medical research or the character of disease or the result of the treatment were ignored. So were studies into the “non-medical” properties of a drug, because the drug is here considered as the object of a doctor's decision making and not as an influencer. Studies into the process of drug adaptation (the mechanism of a doctor's decision making) were largely disregarded. But studies into the effect of a physician's personal characteristics on his prescribing habits were included because these characteristics are an important modifier of the exterior influencers. The studies were classified according to their most significant factor. The model for classification, described in a previous paper,4 was constructed for developed Western countries. It omits some factors, such as the