Healthy Skepticism Library item: 10271

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

Bjornsdottir I, Hansen EH, Grimsson A.
Choosing among antibiotic products: General practitioners' path while prescribing
Journal of Social and Administrative Pharmacy 2003; 20:(4):118-124

Abstract:

Objective: Antibiotic resistance, possibly partially caused by large sales of broad-spectrum antibacterials, has been a problem in Iceland. General practitioners (GPs) are gatekeepers for the sales. Non-therapeutic aspects play a role in their decision-making. The aim of this study was to explore Icelandic GPs’ choice of products, once they have decided to treat. Methods: Ten Icelandic GPs were interviewed (_-2 hours) and three observed (3-10 hours). Whatever our informants said and were observed to do with respect to choosing a product was extracted and analysed, applying Grounded Theory procedures. Setting: General practice in Iceland. Key findings: The process of choosing a product could start by considering one product and extending the range if the considered one was not found suitable or alternatively start with several options and narrowing down, eventually to one. Price seemed to be the most important factor in the decision making, but expected compliance, effect, side effects and contra-indications also played a role, as did the GP’s information sources. Distinction between diagnosis, decision to prescribe and choice of product was sometimes unclear. Conclusion: Consensus regarding choice of products and evidence to achieve one is lacking. However, having a first choice seems to be less likely to cause broad spectrum prescribing than choosing between products without applying specific rules.