title: Factors that influence prescribing within a therapeutic drug class.
abstract: OBJECTIVE
  The decision to prescribe one drug instead of another within the same therapeutic class may be influenced by a variety of drug-related, direct, or indirect factors; but little is known about which considerations are most important in such choices. The low-molecular-weight heparins (LMWHs) represent a class of drugs that are commonly used and for which therapeutic equivalence has been debated in the literature. The purpose of this study was to identify and compare factors perceived by doctors and clinical pharmacists to be influential in prescribing decisions among LMWHs.
  
  
  METHODS
  Doctors and clinical pharmacists were interviewed to elicit information and to rank factors that influence the prescribing and use of LMWHs in community hospitals in the United States. For each factor, the mean and median of the rating were determined along with the frequency distribution across ratings. The non-parametric Mann-Whitney U-test was used to examine differences between doctors and clinical pharmacists.
  
  
  RESULTS
  Both groups considered efficacy, formulary status, and policies restricting drug use to be highly influential in the decision to use one LMWH instead of another. Compared to clinical pharmacists, doctors rated personal experience as more influential, whereas they rated drug cost and prescribing guidelines lower.
  
  
  CONCLUSIONS
  These findings suggest that doctors and clinical pharmacists differentiate between LMWHs based on differences between products and because of hospital administrative programs (such as drug formularies). This information may be of value in designing programs to alter medication use.
authors: Antithrombosis Services, University of Illinois, Chicago, IL, USA.
authors: Edith A
authors: EA
authors: Nutescu
authors: Hayley Y
authors: HY
authors: Park
authors: Surrey M
authors: SM
authors: Walton
authors: Juan C
authors: JC
authors: Blackburn
authors: Jamie M
authors: JM
authors: Finley
authors: Richard K
authors: RK
authors: Lewis
authors: Glen T
authors: GT
authors: Schumock
mesh_terms: D002755:Choice Behavior; D011307:Drug Prescriptions; D006495:Heparin, Low-Molecular-Weight / Q000145:classification / Q000627:therapeutic use*; D006764:Hospitals, Community; D006801:Humans; D010595:Pharmacists; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D006495:Heparin, Low-Molecular-Weight