title: Irrational prescribing of over-the-counter (OTC) medicines in general practice: testing the feasibility of an educational intervention among physicians in five European countries.
abstract: BACKGROUND
  Irrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. Recent findings from a research project funded by the European Commission (FP7), the "OTC SOCIOMED", conducted in seven European countries, indicate that physicians in countries in the Mediterranean Europe region prescribe medicines to a higher degree in comparison to physicians in other participating European countries. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region.
  
  
  METHODS
  This feasibility study utilized an educational intervention was designed using the Theory of Planned Behaviour (TPB). It took place in geographically-defined primary care areas in Cyprus, France, Greece, Malta, and Turkey. General Practitioners (GPs) were recruited in each country and randomly assigned into two study groups in each of the participating countries. The intervention included a one-day intensive training programme, a poster presentation, and regular visits of trained professionals to the workplaces of participants. Reminder messages and email messages were, also, sent to participants over a 4-week period. A pre- and post-test evaluation study design with quantitative and qualitative data was employed. The primary outcome of this feasibility pilot intervention was to reduce GPs' intention to provide medicines following the educational intervention, and its secondary outcomes included a reduction of prescribed medicines following the intervention, as well as an assessment of its practicality and acceptance by the participating GPs.
  
  
  RESULTS
  Median intention scores in the intervention groups were reduced, following the educational intervention, in comparison to the control group. Descriptive analysis of related questions indicated a high overall acceptance and perceived practicality of the intervention programme by GPs, with median scores above 5 on a 7-point Likert scale.
  
  
  CONCLUSIONS
  Evidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions. In addition, it could also help inform health policy makers and decision makers regarding the management of behavioural changes in the prescribing patterns of physicians in Mediterranean Europe, particularly in Southern European countries.
authors.affiliation: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Voutes, PO BOX 2208, Heraklion, P,C, 71003, Greece. lionis@galinos.med.uoc.gr.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.forename: Elena
authors.initials: E
authors.lastname: Petelos
authors.forename: Sue
authors.initials: S
authors.lastname: Shea
authors.forename: Georgia
authors.initials: G
authors.lastname: Bagiartaki
authors.forename: Ioanna G
authors.initials: IG
authors.lastname: Tsiligianni
authors.forename: Apostolos
authors.initials: A
authors.lastname: Kamekis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Tsiantou
authors.forename: Maria
authors.initials: M
authors.lastname: Papadakaki
authors.forename: Athina
authors.initials: A
authors.lastname: Tatsioni
authors.forename: Joanna
authors.initials: J
authors.lastname: Moschandreas
authors.forename: Aristoula
authors.initials: A
authors.lastname: Saridaki
authors.forename: Antonios
authors.initials: A
authors.lastname: Bertsias
authors.forename: Tomas
authors.initials: T
authors.lastname: Faresjö
authors.forename: Ashild
authors.initials: A
authors.lastname: Faresjö
authors.forename: Luc
authors.initials: L
authors.lastname: Martinez
authors.forename: Dominic
authors.initials: D
authors.lastname: Agius
authors.forename: Yesim
authors.initials: Y
authors.lastname: Uncu
authors.forename: George
authors.initials: G
authors.lastname: Samoutis
authors.forename: Jiri
authors.initials: J
authors.lastname: Vlcek
authors.forename: Abobakr
authors.initials: A
authors.lastname: Abasaeed
authors.forename: Bodossakis
authors.initials: B
authors.lastname: Merkouris
mesh_terms: D000328:Adult; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000193:education* / Q000592:standards*; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D010818:Practice Patterns, Physicians'
chemical_list: D004366:Nonprescription Drugs