Physician motivations for nonscientific drug prescribing

Schwartz, Rebecca K.; Soumerai, Stephen B.; Avorn, Jerry

doi:10.1016/0277-9536(89)90252-9

Cited by 220 publications

(102 citation statements)

References 16 publications

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“…The indication is that the pressure to prescribe HT is emanating from women whose quality of life is heavily compromised in view of the distressing symptoms, rather than from GPs. This finding lends some support to existing empirical evidence from the UK that proposes that patients are having an impact on their doctors' behaviour in the realm of drug prescribing (Schwartz et al, 1989;Bradley, 1991). However, unlike our research, these studies have relied on the position of physicians without exploring the patient's perspective.…”

Section: Discussionsupporting

confidence: 76%

Hormone therapy and the medical encounter

Hyde¹,

Nee²,

Drennan³

et al. 2010

Menopause

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HT AND THE MEDICAL ENCOUNTER: A QUALITATIVE ANALYSIS OF WOMEN'S EXPERIENCES AbstractObjective: The aim of this article is to explore women's experiences in biomedical consultations for menopause symptoms, with a particular focus on how Hormone Therapy (HT) featured during the encounter. Methods: Semi-structured interviews were conducted with 39 women and data were analysed using a qualitative strategy referred to as Thematic Networks. Results: Several participants whose menopause started before the period of the HT 'scares' described being 'put on' HT as a matter of course, even where their symptoms were mild. By contrast, some of those presenting in the more recent time period with what they deemed to be severe symptoms were more likely to describe scenarios whereby they pressured their doctors for a HT prescription. Once on HT, participants were found to be far from passive recipients of a biomedical 2 'treatment' but rather embarked on an active dialogue with themselves about how to manage distressing aspects of the menopause. Conclusion: that using HT did not tend to spell a transition to biomedical advocacy, in spite of its reported effectiveness in moderating bodily distresses. Rather, HT tended to retain a tentative status as temporary relief, and not a long-term panacea.

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Section: Discussionsupporting

confidence: 76%

Hormone therapy and the medical encounter

Hyde¹,

Nee²,

Drennan³

et al. 2010

Menopause

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“…21 Second, a change in prescriber behavior whereby prescribers became more likely to prescribe sildenafil without the presence of a comorbid condition. This scenario may be related to healthcare providers' perceptions of patients' hopes of receiving a prescription 30,34 and/or the observed decreased proportion of sildenafil prescriptions prescribed by specialists.…”

Section: Discussionmentioning

confidence: 99%

Patterns of use of sildenafil among commercially insured adults in the United States: 1998–2002

2004

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“…When applying (what scientists call) impure placebos, physicians more or less use conscious rationalization strategies to cope with their dilemma. Apart from perceived demand or expectations of patients, important rationalizations are beliefs in the specific activity of the treatment provided, in spite of conflicting evidence, and arguing for avoidance of potential complications [18].…”

Section: Bad Placebo Interventions and Good Context Effectsmentioning

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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Physician motivations for nonscientific drug prescribing

Cited by 220 publications

References 16 publications

Hormone therapy and the medical encounter

Hormone therapy and the medical encounter

Patterns of use of sildenafil among commercially insured adults in the United States: 1998–2002

Placebo interventions, placebo effects and clinical practice

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