Influence exerted on drug prescribing by patients’ attitudes and expectations and by doctors’ perception of such expectations: a cohort and nested case‐control study

Lado, E.; Vacariza, Manuel; Fernández-González, Carlos; Gestal, Juan; Figueiras, Adolfo

doi:10.1111/j.1365-2753.2007.00901.x

Cited by 23 publications

(24 citation statements)

References 48 publications

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“…They concluded that in daily practice patients do not exert any influence on drug prescription because their prescription expectations are misconstructed by physicians who tend to overestimate them. 23 These results are in line with findings from Cockburn et al who found that, although patients had expectations regarding medication when visiting the physician, the doctors' opinions about the patient expectations were the strongest determinants of prescribing drugs. 24 A fourth factor potentially explaining the broad use of 5-ASA in CD could be that physicians are trying to obtain a placebo effect or to avoid time-consuming explanations of the rationale for not providing the patient with 5-ASA.…”

supporting

confidence: 82%

“…24 A fourth factor potentially explaining the broad use of 5-ASA in CD could be that physicians are trying to obtain a placebo effect or to avoid time-consuming explanations of the rationale for not providing the patient with 5-ASA. 23 Our study has several strengths and also limitations. The first strength is the systematic evaluation of 5-ASA utilisation in a large national cohort.…”

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confidence: 99%

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The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

Schoepfer

Bortolotti

Pittet

et al. 2014

Aliment Pharmacol Ther

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supporting

confidence: 82%

mentioning

confidence: 99%

The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

Schoepfer

Bortolotti

Pittet

et al. 2014

Aliment Pharmacol Ther

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“…A number of studies have demonstrated that a physician's perception of patient expectations positively correlated with prescription rates (2,4,30). Furthermore, the physician's perception of the patient's expectation more strongly predicted antibiotic prescribing than the patient's actual preferences, suggesting that physicians tend to overestimate patients' expectations (26).…”

Section: Discussionmentioning

confidence: 99%

Determinants of Quinolone versus Trimethoprim-Sulfamethoxazole Use for Outpatient Urinary Tract Infection

Stuck

Täuber

Schabel

et al. 2012

Antimicrob Agents Chemother

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Quinolones are increasingly favored over trimethoprim-sulfamethoxazole (TMP-SMX) for empirical treatment of uncomplicated urinary tract infection (UTI). This is associated with increasing resistance toward this broad-spectrum group of antibiotics. Our objective is to describe the prescribing patterns and identify determinants of the choice between TMP-SMX and quinolones for outpatient UTI treatment in Switzerland. An ongoing national Sentinel surveillance system was used to study 11,799 antibiotic prescriptions for UTI in adult outpatients and associated physician and patient factors between 2006 and 2008, to compare the prescription of quinolones versus that of TMP-SMX for treatment of UTI. Most UTI episodes were diagnosed as cystitis (90%). TMP-SMX was prescribed for one-fifth (22%) of UTIs. Independent predictors for prescribing quinolones were pyelonephritis and physicians with low thresholds for prescribing antibiotics for upper respiratory tract infections ("high prescribers"), whereas female patients were more likely to receive TMP-SMX. High-prescribing physicians also more often cared for patients who themselves favor antibiotic treatment (P < 0.001). Quinolones are commonly prescribed to outpatients with UTI. Nonclinical factors influence the choice of quinolones versus TMP-SMX, which may provide opportunities for interventions to improve prescribing patterns and control quinolone resistance.

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“…There is some data that physicians overestimate the extent to which patients expect a prescription [19], suggesting that other, possibly subconscious, reasons might also play a role. Placebo prescription in such a situation is not a case of deception, but a conflict between the professional integrity of the physician and the patient's wish [8].…”

Section: What Is a Placebo Intervention In Clinical Practice?mentioning

confidence: 99%

Placebo interventions, placebo effects and clinical practice

Linde

Fässler

Meißner

2011

Phil. Trans. R. Soc. B

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This article reviews the role of placebo interventions and placebo effects in clinical practice. We first describe the relevance of different perspectives among scientists, physicians and patients on what is considered a placebo intervention in clinical practice. We then summarize how placebo effects have been investigated in randomized controlled trials under the questionable premise that such effects are produced by placebo interventions. We further discuss why a shift of focus from the placebo intervention to the overall therapeutic context is necessary and what research methods can be used for the clinical investigation of the relevance of context effects. In the last part of the manuscript, we discuss why placebo or context effects are seen as positive in clinical practice when they are associated with active treatments, while placebo interventions pose major ethical and professional problems and have to be avoided.

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Influence exerted on drug prescribing by patients’ attitudes and expectations and by doctors’ perception of such expectations: a cohort and nested case‐control study

Abstract: We conclude that, although doctors prescribe in accordance with what they believe their patients expect, in practice patients exert no influence on drug prescribing because their prescription expectations are misconstrued by doctors, who overestimate them.

Cited by 23 publications

References 48 publications

The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

The gap between scientific evidence and clinical practice: 5‐aminosalicylates are frequently used for the treatment of Crohn's disease

Determinants of Quinolone versus Trimethoprim-Sulfamethoxazole Use for Outpatient Urinary Tract Infection

Placebo interventions, placebo effects and clinical practice

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