Attitudes towards prescribing cognitive enhancers among primary care physicians in Germany

Abstract

BackgroundPrimary 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.MethodsA 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.Results96.0% 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.ConclusionsAlthough 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.

Attitudes toward pharmacological cognitive enhancement—a review

“…Franke et al (2014) confirmed these findings in a paper and pencil questionnaire study among 832 German physicians. In both studies, physicians worried about misuse and deemed PCE for young people to be unnecessary.…”

“…Furthermore, 212 US American and Canadian physicians, reported in an online survey, being less comfortable prescribing PCE substances for non-medical use to young adults, compared to older patients (Banjo et al, 2010 ). Franke et al ( 2014 ) confirmed these findings in a paper and pencil questionnaire study among 832 German physicians. In both studies, physicians worried about misuse and deemed PCE for young people to be unnecessary.…”

Pharmacological Neuroenhancement: Current Aspects of Categorization, Epidemiology, Pharmacology, Drug Development, Ethics, and Future Perspectives

“…Consequently, pNE applicants either purport a fictive medical need to the attending physician or directly consult their doctors for prescription of pharmacological neuroenhancers. The latter was reported by 40.8% of general practitioners [ 112 ]. It should be stated again that from a prescriptive point of view, these cases should not exist, and doctors should not service these accessibility strategies.…”

Et udstrakt selv

“…I Europa er forskning i IMRMK temmelig begraenset. Gennem de seneste fem år har enkelte, hovedsageligt survey-baserede, studier (Schelle et al, 2015;Maier et al, 2013;Lengvenyte & Strumila, 2016;Middendorff et al, 2012;Eickenhorst et al, 2012;Franke et al, 2014) dog vist, at IMRMK også forekommer i Europa. Disse studier indikerer en stigning i IMRMK om end i mindre omfang end i USA.…”