Use of Psychotropic Drug Prescriptions in a Prepaid Group Practice Plan

Physical ill-health and psychotropic drug prescription – a review

“…During the week of the survey, 761 prescriptions for psychotropic drugs were written, and for 68% (517) of these a physical diagnosis was recorded. Baron & Fisher (1962) investigated prescriptions written by physicians in a similar organization, the Group Health Association of Washington. Prescriptions written for a stratified sample of patients during 4 separate weeks (1 in each season of the year in 1958 and 1959) were studied.…”

“…Part of this may be accounted for by the differences in sampling unit described above, but another factor is the type of doctor writing the prescription. Shapiro & Baron (1961) and Baron & Fisher (1962) both sampled prescriptions written by physicians working in a private practice organization, and the studies of Baiter & Levine (1969) and Parry et al (1973) were of prescriptions written by 'physicians in private practice', each of these groups containing a number of specialist physicians (internists). Baron & Fisher (1962) draw attention to 'the tendency of non-psychiatric physicians to record only the physical and not the psychiatric aspects of the patient's illness'.…”

“…Shapiro & Baron (1961) and Baron & Fisher (1962) both sampled prescriptions written by physicians working in a private practice organization, and the studies of Baiter & Levine (1969) and Parry et al (1973) were of prescriptions written by 'physicians in private practice', each of these groups containing a number of specialist physicians (internists). Baron & Fisher (1962) draw attention to 'the tendency of non-psychiatric physicians to record only the physical and not the psychiatric aspects of the patient's illness'. Both the British studies were in general practice and, therefore, the characteristics of the prescription writers may account for some of the US-UK variation, although the possibility that there are real differences in prescribing patterns between the 2 countries cannot be discounted.…”

“…Of the community surveys which have investigated prescribers' diagnosis in relation to psychotropic drug prescription, only 3 address themselves to this question (Shapiro & Baron, 1961;Baiter & Levine, 1969;Parry et al 1973), while Baron & Fisher (1962) quote figures for 6 not especially representative drugs. Of the 3 groups of psychotropic drugs listed in Table 1, antidepressants appear to be the least commonly prescribed for a physical diagnosis.…”

The Use of Psychotherapeutic Drugs by Middle-Aged Women

“…The second study of psychotherapeutic drug use (Shapiro and Baron, 1961; Baron * The research reported here was financed by the Social Security Administration (HEW), Contract #SSA 70-2758. andFisher, 1962) were based upon prescription records for a population enrolled in a prepaid medical care program. But as Mellinger and his associates (1970) have pointed out, studies of this design have been more useful in providing insight into the prescribing habits of physicians than into the dynamics of patient drug use.…”