title: Decision making and physician prescribing characteristics: a pilot study of Japanese physicians.
abstract: The factors that affect physicians' prescribing remain unclear. Although previous reports suggest that prescription decisions are associated with various clinical situation, most of these studies analyzed simulated patient models rather than actual clinical practice. Here, we retrospectively analyzed actual cases of statin prescription for hyperlipidemia at Tohoku University Hospital between Apr 1, 2004 and Mar 31, 2008. Twelve physicians (6 cardiologists, 3 nephrologist, and 3 diabetologist) made decisions on whether to prescribe statins to 187 patients in 788 visits. As expected, cardiologists started prescribing statins at significantly lower serum total cholesterol levels than other specialists (221.7mg/dL vs. 244.7mg/dL, P<0.05). Interestingly, the total cholesterol levels that triggered prescribing differed significantly among cardiologists (p<0.05). These results suggested that prescription decisions differed not only among specialties but also among individuals.
authors.affiliation: Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shibuya
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nakayama
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kondo
mesh_terms: D000368:Aged; D044466:Asian People; D002309:Cardiology; D002784:Cholesterol / Q000097:blood*; D003657:Decision Making; D011307:Drug Prescriptions; D004704:Endocrinology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D008297:Male; D050316:Medical Order Entry Systems; D008499:Medical Records; D008875:Middle Aged; D009398:Nephrology; D010820:Physicians / Q000523:psychology*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol