title: Attitudes towards prescribing cognitive enhancers among primary care physicians in Germany.
abstract: BACKGROUND
  Primary care physicians are gate keepers to the medical system having a key role in giving information and prescribing drugs to their patients. In this respect they are involved in claims of patients/clients for pharmacological Cognitive Enhancement (CE). Therefore, we studied the knowledge of primary care physicians about CE and their attitudes toward prescribing CE drugs to healthy subjects.
  
  
  METHODS
  A self-report paper-and-pencil questionnaire and case vignettes describing a hypothetical CE drug were sent out to all 2,753 registered primary care physicians in Rhineland Palatine, Germany. 832, i.e. 30.2% filled in the questionnaire anonymously.
  
  
  RESULTS
  96.0% of all participating physicians had already heard about CE. However, only 5.3% stated to be very familiar with this subject and 43.5% judged themselves as being not familiar with CE. 7.0% had been asked by their clients to prescribe a drug for CE during the last week, 19.0% during the last month, and 40.8% during the last year. The comfort level to prescribe CE drugs was very low and significantly lower than to prescribe sildenafil (Viagra®). Comfort level was mainly affected by the age of the client asking for prescription of CE drugs, followed by the availability of non-pharmacological alternatives, fear of misuse of the prescribed drug by the client and the missing indication of prescribing a drug.
  
  
  CONCLUSIONS
  Although a relatively high proportion of primary care physicians have been asked by their clients to prescribe CE drugs, only a small proportion are well informed about the possibilities of CE. Since physicians are gate keepers to the medical system and have a key role regarding a drugs' prescription, objective information should be made available to physicians about biological, ethical and social consequences of CE use.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Untere Zahlbacher Str, 17, D - 55128 Mainz, Germany. afranke@uni-mainz.de.
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Franke
authors.forename: Carolin
authors.initials: C
authors.lastname: Papenburg
authors.forename: Elena
authors.initials: E
authors.lastname: Schotten
authors.forename: Peter B
authors.initials: PB
authors.lastname: Reiner
authors.forename: Klaus
authors.initials: K
authors.lastname: Lieb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D058007:Physicians, Primary Care; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D018697:Nootropic Agents