[Relevance of general practitioner's prescriptions for hospital pharmacotherapy. A survey of hospital physicians].
OBJECTIVE
At hospital admission drugs prescribed by the general practitioner (GP) are often changed. This may have a negative impact on the relationship between family and hospital physicians as well as on the family doctor-patient-relationship. The study set out to examine the attitudes of hospital physicians towards GPs' prior ambulatory medication, especially in the case of drugs of unproven efficacy (e.g. certain drug combinations and homeopathic or herbal drugs).


METHODS
A total of 129 doctors of the surgical and medical wards of the Göttingen University Hospital received a standardized questionnaire focusing on drugs prescribed by referring GPs (response rate: 65.9%). Three case vignettes were presented describing "popular" GP prescriptions. Doctors of surgical and medical departments were asked whether or not they would follow these prescriptions. Differences in the answers between the groups of doctors were tested by Fisher's exact test.


RESULTS
More doctors on the surgical than on the medical wards would usually follow GPs' medication (82 vs 25%; P < 0.001). According to these attitudes, more doctors of medical departments would stop the prescription of drug combination (82 vs 41%; P < 0.001); both groups would be hesitant to accept homeopathic drugs (89 vs 59%; P < 0.01) or herbal drugs (89 vs 55%; P < 0.01) as prescribed by the GP. The critical attitude especially of doctors of the medical departments towards drug combinations and herbal drugs was in line with their decision in the case vignettes (e.g. Capozide, Tebonin forte).


CONCLUSIONS
Especially doctors working in medical departments keep in line with conventional clinical pharmacological criteria. If they have to decide whether or not to follow patients' ambulatory medication, they may overlook GPs' decision-making process underlying their prescribing.
Himmel
W
W
Abteilung Allgemeinmedizin, Universität Göttingen.
Lönker
B
B
Kochen
M M
MM
D000368:Aged; D001291:Attitude of Health Personnel; D002216:Captopril / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000188:drug therapy; D004338:Drug Combinations; D011307:Drug Prescriptions; D004358:Drug Therapy; D005194:Family Practice; D005260:Female; D005419:Flavonoids / Q000627:therapeutic use; D020441:Ginkgo biloba; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010936:Plant Extracts; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D012855:Sitosterols / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D000096983:Ginkgo Extract
D002216:Captopril; D004338:Drug Combinations; D005419:Flavonoids; D006490:Hemostatics; D006852:Hydrochlorothiazide; D010936:Plant Extracts; D012855:Sitosterols; C044959:captopril, hydrochlorothiazide drug combination; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract; C025473:gamma-sitosterol