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Author List:
Young G (Center for Organization, Leadership and Management Research)
Mohr D (Center for Organization, Leadership and Management Research)
Meterko M (Center for Organization, Leadership and Management Research)
Nealon-Seibert M (Center for Organization, Leadership and Management Research)
McGlynn G (Center for Organization, Leadership and Management Research)
Objectives:
To identify characteristics of physicians influencing their adherence to evidence-based recommendations for prescribing medications. Previous research has focused primarily on the overall degree of adherence within a community of physicians with relatively little attention to those factors associated with higher or lower adherence among individual physicians.
Methods:
The study was conducted as an observational design involving a survey of psychiatrists. The survey was sent to 1757 psychiatrists who were all affiliated with the Veterans Health Administration (VA). The survey questionnaire solicited information from respondents for assessing adherence to three recommended prescribing practices for using antipsychotics. Adherence was defined as reportedly following a recommended practice for at least 75 percent of one’s patients. Independent variables were selected in accordance with a conceptual model that has been used previously to study physician prescribing behavior. The variables pertained to physician demographic and practice setting characteristics as well as the sources of information used to stay current with evidence-based prescribing practices.
Results:
The survey yielded a response rate of approximately 40%. Respondents did not differ from non-respondents for most demographic and practice setting characteristics. Adherence for the three practices ranged between 76 and 81 percent. Post-residency experience, larger caseload of patients with schizophrenia, sex, relatively greater use of published scientific literature as well as drug company information were associated with adherence to one or more of the recommended practices. More than half of the psychiatrists in the study sample reportedly adhered to all three recommended practices.
Implications:
Among psychiatrists in the study sample, compliance with the recommended prescribing practices was relatively high. A combination of characteristics appears to be associated with physician adherence to evidence-based prescribing practices. Physicians who are more inclined to adhere (not adhere) to one evidence-based practice appear to be more inclined to adhere (not adhere) to other evidence-based practices.
Impacts:
By understanding the backgrounds and behaviors of physicians that are most closely associated with adherence, policy makers and managers can more efficiently and effectively disseminate evidence about prescribing practices to physicians. Study results are an important step to providing that guidance.
