Hospital doctors' views of factors influencing their prescribing.

Abstract:

RATIONALE, AIM AND OBJECTIVE:Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in prescribing drugs, using a qualitative approach. METHOD:Semi-structured interviews were conducted with 15 hospital doctors in different medical specialities and the interviews were analysed from an interpretivist perspective. The information gathered was on how prescribing decisions were made in general and how the doctors chose a specific drug therapy, including information sources used. RESULTS:According to our interviews, the hospital doctors took patient-specific factors and cost into consideration when prescribing, informed by different written information sources and commercial verbal information. Personal practice, colleagues and therapeutic tradition at the hospital or clinic, were influential in the prescribing of drugs. The themes identified should not to be seen as individual influences; many of them probably act in combination. CONCLUSIONS:If changes in prescribing behaviour are desired, factors warranting more attention include understanding how to influence therapeutic traditions and the doctor's personal habits for prescribing. The importance of clinical experience and information exchange with colleagues should not be underestimated in providing information about drugs to hospital doctors.

journal_name

J Eval Clin Pract

authors

Ljungberg C,Lindblad AK,Tully MP

doi

10.1111/j.1365-2753.2006.00751.x

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

765-71

issue

5

eissn

1356-1294

issn

1365-2753

pii

JEP751

journal_volume

13

pub_type

杂志文章
  • Using VLAD scores to have a look insight ICU performance: towards a modelling of the errors.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Mortality prediction models using logistic regression analysis play a pivotal role in intensive care quality evaluation, allowing a hospital's performance to be compared with a standard. However, when a difference between predicted and observed mortality exists, that is, the numerator of ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2009.01240.x

    authors: Foltran F,Berchialla P,Giunta F,Malacarne P,Merletti F,Gregori D

    更新日期:2010-10-01 00:00:00

  • Managing asthma in primary care through imperative outcomes.

    abstract:RATIONALE, AIMS AND OBJECTIVES:To evaluate asthma management and control in primary care clinics so as to design improvements based on guideline-directed outcomes. METHODS:In this study, all medical records of asthma-diagnosed patients (children as well as adults, entire lifespan, asthma-related visits or not) were re...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2011.01803.x

    authors: du Plessis JM,Gerber JJ,Brand L

    更新日期:2013-04-01 00:00:00

  • Comparison of the metabolic and economic consequences of long-term treatment of schizophrenia using ziprasidone, olanzapine, quetiapine and risperidone in Canada: a cost-effectiveness analysis.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Second-generation antipsychotic agents have varying propensities to cause weight gain, elevated lipid levels and associated long-term complications. This study evaluates the cost-effectiveness of four second-generation antipsychotic agents used in Canada for the treatment of schizophrenia...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2009.01189.x

    authors: McIntyre RS,Cragin L,Sorensen S,Naci H,Baker T,Roussy JP

    更新日期:2010-08-01 00:00:00

  • Clinical thinking in psychiatry.

    abstract::I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer m...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12324

    authors: Wells LA

    更新日期:2015-06-01 00:00:00

  • HIT or miss: the application of health care information technology to managing uncertainty in clinical decision making.

    abstract:OBJECTIVE:To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. STUDY DESIGN:An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2010.01483.x

    authors: Kazandjian VA,Lipitz-Snyderman A

    更新日期:2011-12-01 00:00:00

  • Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12306

    authors: Bell CA,Ilomäki J,Pichenda K,Duncan GJ,Saini B

    更新日期:2015-04-01 00:00:00

  • Therapist self-disclosure and the problem of shared-decision making.

    abstract::Therapist self-disclosure is one of the most controversial topics in the history of psychotherapy. The controversies reflect some basic discussions regarding the nature of psychotherapy practice. In psychotherapy practice, a particular concern is the interaction between the psychotherapist and the patient. The expert-...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13289

    authors: Berg H,Bjornestad J,Våpenstad EV,Davidson L,Binder PE

    更新日期:2020-04-01 00:00:00

  • Secondary care doctors' perception of appropriate prescribing.

    abstract:RATIONALE, AIM AND OBJECTIVE:As the prescribing of drugs in secondary care is known to influence prescribing in primary care and because an understanding of prescribers' reasoning is essential for evaluating prescribing appropriateness, the aim of this study was to investigate secondary care doctors' views of appropria...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2008.00963.x

    authors: Ljungberg C,Lindblad AK,Tully M

    更新日期:2009-02-01 00:00:00

  • Automated calculation of ptosis on lateral clinical photographs.

    abstract:RATIONALE, AIMS AND OBJECTIVES:The goal is to fully automate the calculation of a breast ptosis measure from clinical photographs through automatic localization of fiducial points relevant to the measure. METHODS:Sixty-eight women (97 clinical photographs) who underwent or were scheduled for breast reconstruction were...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12397

    authors: Lee J,Kim E,Reece GP,Crosby MA,Beahm EK,Markey MK

    更新日期:2015-10-01 00:00:00

  • Polanyi's tacit knowing and the relevance of epistemology to clinical medicine.

    abstract::Most clinicians take for granted a simple, reductionist understanding of medical knowledge that is at odds with how they actually practice medicine; routine medical decisions incorporate more complicated kinds of information than most standard accounts of medical reasoning suggest. A better understanding of the struct...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2010.01387.x

    authors: Henry SG

    更新日期:2010-04-01 00:00:00

  • Morbidity figures from general practice: sex differences in traumatology.

    abstract:BACKGROUND:Trauma prevention starts with to find out the extent of the problem and who it affects. Insight into morbidity figures is therefore necessary. AIM:To explore sex differences in traumatology and secondary medical care utilization in primary care related to age and socio-economic status (SES). METHODS:Data w...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2009.01172.x

    authors: Lagro-Janssen T,Grosicar J

    更新日期:2010-08-01 00:00:00

  • What is knowledge and when should it be implemented?

    abstract::A primary purpose of research is to generate new knowledge. Scientific advances have progressively identified optimal ways to achieve this purpose. Included in this evolution are the notions of evidence-based medicine, decision aids, shared decision making, measurement and evaluation as well as implementation. The imp...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2012.01899.x

    authors: O'Grady L

    更新日期:2012-10-01 00:00:00

  • What determines the management of anxiety disorders and its improvement?

    abstract:INTRODUCTION:Although anxiety disorders are highly prevalent, lack of correct diagnosis and related concerns about treatment are serious clinical problems. Several factors affect, positively or negatively, management of anxiety and its improvement. A literature review and thematic analysis was executed to obtain an ove...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2753.2007.00845.x

    authors: Smolders M,Laurant M,van Wamel A,Grol R,Wensing M

    更新日期:2008-04-01 00:00:00

  • Trust and world view in shared decision making with indigenous patients: A realist synthesis.

    abstract:INTRODUCTION:How shared decision making (SDM) works with indigenous patient values and preferences is not well understood. Colonization has affected indigenous peoples' levels of trust with institutions, and their world view tends to be distinct from that of nonindigenous people. Building on a programme theory for SDM,...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13307

    authors: Groot G,Waldron T,Barreno L,Cochran D,Carr T

    更新日期:2020-04-01 00:00:00

  • The mind electric: Challenges to clinical categories from a person-centred perspective and the possibilities of metaphysics and art for clinician, patient, and treatment.

    abstract::The paper proposes that frameworks typical to metaphysics and art could be used in clinical treatment in somatic and psychiatric contexts to ensure improved care. The concept of the "body electric" of somatic patients which I introduced in previous work is developed further and paired with the "mind electric" of psych...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12964

    authors: Pârvan A

    更新日期:2018-10-01 00:00:00

  • Implementation of patient involvement methods in the clinical setting: A qualitative study exploring the health professional perspective.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Patient involvement is increasingly recognized as a key component on the international health care agenda. This attention has brought a need for developing generic and standardized open-source methods, tools, and guidelines on how to systematically implement patient involvement initiative...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13217

    authors: Jørgensen MJ,Pedersen CG,Martin HM,Lomborg K

    更新日期:2020-06-01 00:00:00

  • Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Following increased interest in having inter-professional (IP) health care teams engage patients in decision making, we developed a conceptual model for an IP approach to shared decision making (SDM) in primary care. We assessed the validity of the model with stakeholders in Canada. METH...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/j.1365-2753.2010.01515.x

    authors: Légaré F,Stacey D,Gagnon S,Dunn S,Pluye P,Frosch D,Kryworuchko J,Elwyn G,Gagnon MP,Graham ID

    更新日期:2011-08-01 00:00:00

  • Examining the implementation of clinical practice guidelines for the management of adult cancers: A mixed methods study.

    abstract:RATIONALE, AIMS, AND OBJECTIVES:Focusing on the implementation of clinical practice guidelines (CPGs) for the management of adult cancers, the objectives of this study were to (a) describe the intrinsic elements known to influence CPG use; (b) identify the ways in which CPGs are implemented; and (c) explore how CPG cha...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13073

    authors: Urquhart R,Woodside H,Kendell C,Porter GA

    更新日期:2019-08-01 00:00:00

  • A climate for evidence-based practice implementation in the patient-centred medical home.

    abstract:INTRODUCTION:The patient-centred medical home (PCMH) is an important part of health care reform. While there is hope, the PCMH model can facilitate the provision of higher quality care, the extent to which organizational climate within the PCMH supports the implementation of evidence-based practices (EBPs) is unknown. ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13050

    authors: Sklar M,Hatch MR,Aarons GA

    更新日期:2019-08-01 00:00:00

  • Reasons for not reporting adverse incidents: an empirical study.

    abstract::A previous study (Stanhope et al. 1998) established that staff in two obstetric units reported less than a quarter of designated incidents to the units' risk managers. A questionnaire was administered to 42 obstetricians and 156 midwives at the same two obstetric units, exploring the reasons for low rates of reporting...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1046/j.1365-2753.1999.00147.x

    authors: Vincent C,Stanhope N,Crowley-Murphy M

    更新日期:1999-02-01 00:00:00

  • Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study.

    abstract:RATIONALE, AIMS AND OBJECTIVES:The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADC...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12445

    authors: Fanning L,Jones N,Manias E

    更新日期:2016-04-01 00:00:00

  • Reasoning, evidence, and clinical decision-making: The great debate moves forward.

    abstract::When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 社论

    doi:10.1111/jep.12831

    authors: Loughlin M,Bluhm R,Buetow S,Borgerson K,Fuller J

    更新日期:2017-10-01 00:00:00

  • Which risk-adjustment index performs better in predicting 30-day mortality? A systematic review and meta-analysis.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Individual comparisons of the performance of risk-adjustment indices have been widely conducted. Few reviews have been conducted to summarize the performance of different risk-adjustment indices. A 30-day mortality rate is widely used to evaluate the quality of care in hospitals by federa...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/jep.12307

    authors: Yang M,Mehta HB,Bali V,Gupta P,Wang X,Johnson ML,Aparasu RR

    更新日期:2015-04-01 00:00:00

  • From MARS to MAGIC: The remarkable journey through time and space of the Grading of Recommendations Assessment, Development and Evaluation initiative.

    abstract::For over 30 years, "evidence-based" clinical guidelines remained entrenched in an oversimplified, design-based, framework for rating the strength of evidence supporting clinical recommendations. The approach frequently equated the rating of evidence with that of the recommendations themselves. "Grading Recommendations...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13019

    authors: Wyer PC

    更新日期:2018-10-01 00:00:00

  • Outpatient versus inpatient laparoscopic cholecystectomy: a prospective randomized study of symptom occurrence, symptom distress and general state of health during the first post-operative week.

    abstract:BACKGROUND:Few randomized clinical trials focus on patients' symptoms of the first post-operative week following outpatient (OPS) versus inpatient (IPS) laparoscopic cholecystectomy (LC). The objective was to compare these treatment modalities with regard to patients' perceptions of pain and other post-operative sympto...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2753.2007.00920.x

    authors: Barthelsson C,Anderberg B,Ramel S,Björvell C,Giesecke K,Nordström G

    更新日期:2008-08-01 00:00:00

  • Assessing the methodological quality of the Canadian Psychiatric Association's anxiety and depression clinical practice guidelines.

    abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) endeavour to incorporate the best available research evidence together with the clinically informed opinions of leading experts in order to guide clinical practice when dealing with a given condition. There has been increased interest in CPGs that are ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.13026

    authors: Middleton JC,Kalogeropoulos C,Middleton JA,Drapeau M

    更新日期:2019-08-01 00:00:00

  • Interpretation of tests of heterogeneity and bias in meta-analysis.

    abstract::Statistical tests of heterogeneity and bias, in particular publication bias, are very popular in meta-analyses. These tests use statistical approaches whose limitations are often not recognized. Moreover, it is often implied with inappropriate confidence that these tests can provide reliable answers to questions that ...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2753.2008.00986.x

    authors: Ioannidis JP

    更新日期:2008-10-01 00:00:00

  • Test-retest reliability of the VA National Center for Patient Safety culture questionnaire.

    abstract:RATIONALE, AIMS AND OBJECTIVES:Patient safety culture may have a significant influence on safety processes and outcomes. Therefore, it is important to have valid tools to measure patient safety culture in order to identify potential levers for cultural change that could improve patient safety. The 65-item Department of...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1111/jep.12589

    authors: Shiner B,Ronconi JM,McKnight S,Young-Xu Y,Mills PD,Watts BV

    更新日期:2016-12-01 00:00:00

  • Reflexivity and metapositions: strategies for appraisal of clinical evidence.

    abstract::According to Sackett, evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. In this article, clinical reasoning is depicted as multilayered processes of evidence construction by means of social interaction and hum...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章

    doi:10.1046/j.1365-2753.2002.00353.x

    authors: Malterud K

    更新日期:2002-05-01 00:00:00

  • Evaluating disease management programme effectiveness: an introduction to the regression discontinuity design.

    abstract::Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most not...

    journal_title:Journal of evaluation in clinical practice

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2753.2005.00573.x

    authors: Linden A,Adams JL,Roberts N

    更新日期:2006-04-01 00:00:00