title: General Practitioners' intention to prescribe and prescribing patterns in selected European settings: The OTCSOCIOMED project.
abstract: The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.
authors.affiliation: Department of Health Economics, National School of Public Health, 196 Alexandras Avenue, 11521 Athens, Greece; Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003, Greece. Electronic address: vtsiantou@esdy.edu.gr.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Tsiantou
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion 71003, Crete, Greece. Electronic address: j.moschandreas@med.uoc.gr.
authors.forename: Joanna
authors.initials: J
authors.lastname: Moschandreas
authors.affiliation: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003, Greece. Electronic address: antonisbertsias@yahoo.gr.
authors.forename: Antonis
authors.initials: A
authors.lastname: Bertsias
authors.affiliation: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003, Greece. Electronic address: mpapadakaki@yahoo.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Papadakaki
authors.affiliation: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003, Greece. Electronic address: asaridaki@med.uoc.gr.
authors.forename: Aristoula
authors.initials: A
authors.lastname: Saridaki
authors.affiliation: Mediterranean Institute of Primary Care, 19, Triqir-Rand, Attard, Malta. Electronic address: domagius@go.net.mt.
authors.forename: Dominic
authors.initials: D
authors.lastname: Agius
authors.affiliation: University of Uludag, Faculty of Medicine Department of Family Practice, Department of Medical Education, Bursa, Turkey; Turkish Association of Family Physicians, (TAHUD), Turkey. Electronic address: zalper@uludag.edu.tr.
authors.forename: Zuleyha
authors.initials: Z
authors.lastname: Alper
authors.affiliation: Department of Medicine and Health/Community Medicine General Practice, Faculty of Health Sciences, Linkoping University, SE-581 83 Linkoping, Sweden. Electronic address: tomas.faresjo@liu.se.
authors.forename: Tomas
authors.initials: T
authors.lastname: Faresjo
authors.affiliation: Charles University in Prague, Faculty of Pharmacy in Hradec Kralove, Czech Republic. Electronic address: Martina.klimkova@gmail.com.
authors.forename: Martina
authors.initials: M
authors.lastname: Klimkova
authors.affiliation: Sorbonne Universités, UPMC University Paris 06, INSERM, UMR_S 1136, Institute Pierre Louis of Epidemiologie and Public Health, Team EPAR, F-75013 Paris, France; Société Française de Médecine Générale, 141, avenue de Verdun, 92130 ISSY LES MOULINEAUX, France. Electronic address: luc.martinez@wanadoo.fr.
authors.forename: Luc
authors.initials: L
authors.lastname: Martinez
authors.affiliation: St George's, University of London medical programmedelivered in Cyprus by the University of Nicosia Medical School, Cyprus. Electronic address: g.samoutis@sgul.ac.uk.
authors.forename: George
authors.initials: G
authors.lastname: Samoutis
authors.affiliation: Charles University in Prague, Faculty of Pharmacy in Hradec Kralove, Czech Republic. Electronic address: vlcek@faf.cuni.cz.
authors.forename: Jiří
authors.initials: J
authors.lastname: Vlček
authors.affiliation: Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003, Greece. Electronic address: lionis@galinos.med.uoc.gr.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
mesh_terms: D000328:Adult; D003535:Cyprus; D018153:Czech Republic; D005260:Female; D005602:France; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D006115:Greece; D006801:Humans; D033182:Intention; D008297:Male; D008319:Malta; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013548:Sweden; D014421:Turkey
keywords: General practitioner; Prescribing; Primary care; Theory of Planned Behavior