Healthy Skepticism Library item: 395

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Lexchin J.
Improving the appropriateness of physician prescribing.
Int J Health Serv 1998; 28:(2):253-67

Abstract:

Appropriate prescribing means that prescribers should try to maximize effectiveness, minimize risks and costs, and respect patients’ choices. Evidence from studies on prescribing to individuals and from administrative databases reveals a significant level of inappropriate prescribing by Canadian physicians. Two important reasons for inappropriate prescribing seem to be physicians’ level of knowledge and physicians’ practice settings. A large number of methods have been tried to improve prescribing behavior, but most are unsuccessful. Academic detailing, and audit and feedback, have both been shown to work but may be difficult to implement in Canada, where most physicians practice in solo fee-for-service settings. Alternative forms of physician payment such as capitation or salary are probably necessary to make prescribing more appropriate.