Prescribing new drugs: qualitative study of influences on consultants and general practitioners.
OBJECTIVE
To explore consultants' and general practitioners' perceptions of the factors that influence their decisions to introduce new drugs into their clinical practice.


METHODS
Qualitative study using semistructured interviews. Monitoring of hospital and general practice prescribing data for eight new drugs.


METHODS
Teaching hospital and nearby general hospital plus general practices in Birmingham.


METHODS
38 consultants and 56 general practitioners who regularly referred to the teaching hospital.


METHODS
Reasons for prescribing a new drug; sources of information used for new drugs; extent of contact between consultants and general practitioners; and amount of study drugs used in hospitals and by general practitioners.


RESULTS
Consultants usually prescribed new drugs only in their specialty, used few new drugs, and used scientific evidence to inform their decisions. General practitioners generally prescribed more new drugs and for a wider range of conditions, but their approach varied considerably both between general practitioners and between drugs for the same general practitioner. Drug company representatives were an important source of information for general practitioners. Prescribing data were consistent with statements made by respondents.


CONCLUSIONS
The factors influencing the introduction of new drugs, particularly in primary care, are more multiple and complex than suggested by early theories of drug innovation. Early experience of using a new drug seems to strongly influence future use.
Jones
M I
MI
Department of Primary Care and General Practice, Medical School, University of Birmingham, Birmingham B15 2TT. M.I.Jones@bham.ac.uk
Greenfield
S M
SM
Bradley
C P
CP
D004345:Drug Industry; D004363:Drug Utilization; D019317:Evidence-Based Medicine; D006801:Humans; D008505:Medical Staff, Hospital; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research