General practitioners' views on using a prescribing substitution application (ScriptSwitch(®)).

Carly Hire, Bruno Rushforth
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引用次数: 8

Abstract

Background: General practitioners (GPs) are increasingly pressured to prescribe cost-effectively, due to rising prescribing expenditure and limited budgets. A computerised prescribing substitution application (ScriptSwitch(®)) provides 'pop-ups' of cost-saving drug switches at the point of prescribing. It has been used by some United Kingdom local health commissioning organisations as part of a medicines management strategy.

Objective: To explore GPs' views on using this prescribing substitution application in their day-to-day clinical practice.

Methods: Qualitative study employing face-to-face semi-structured interviews, undertaken with a convenience sample of eight GPs across five practices within one local health commissioning area in the North of England. Interviews were audio-recorded, transcribed verbatim and thematically analysed.

Results: Six themes were identified including: (1) GPs' acceptance, (2) the application's impact, (3) external control, (4) disruption to workflow, (5) GP willingness to switch and (6) patient willingness to switch.

Conclusions: Clinician, patient and organisational factors were identified which were assumed by GPs to affect the engagement with the application. Despite general acceptance of the application to enhance cost-effective prescribing, its impact was perceived to be limited within the context of existing cost-effective prescribing initiatives. The application's perceived lack of 'learning'-e.g. offering the same switch despite the prescriber repeatedly declining this-devalued users' confidence in it. With patients varying in amenability and acceptance to drug switches, GPs appear to experience tension between considering individual patient choice and wider practice population prescribing priorities. Giving GPs more control in adapting the application to their own local prescribing priorities may enhance its success.

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全科医生对使用处方替代应用程序(ScriptSwitch(®))的看法。
背景:由于处方支出的增加和有限的预算,全科医生(全科医生)的处方成本效益越来越大。计算机化的处方替代应用程序(ScriptSwitch(®))在开处方时提供节省成本的药物转换的“弹出窗口”。它已被联合王国一些地方卫生委托组织用作药品管理战略的一部分。目的:探讨全科医生在日常临床实践中对处方替代应用的看法。方法:定性研究采用面对面的半结构化访谈,在英格兰北部一个地方卫生委托区内的五个实践中进行了八个全科医生的方便样本。采访录音,逐字抄录,并按主题进行分析。结果:确定了六个主题,包括:(1)全科医生的接受程度,(2)应用程序的影响,(3)外部控制,(4)工作流程的中断,(5)全科医生的转换意愿和(6)患者的转换意愿。结论:临床医生、患者和组织因素被确定,这些因素被全科医生认为会影响应用程序的参与。尽管普遍接受了提高具有成本效益的处方的应用,但在现有具有成本效益的处方举措的背景下,其影响被认为是有限的。应用程序被认为缺乏“学习”——例如:提供同样的开关,尽管处方者一再拒绝,这降低了用户对它的信心。随着患者对药物转换的适应和接受程度的变化,全科医生似乎在考虑个体患者选择和更广泛的实践人群处方优先级之间经历了紧张。给全科医生更多的控制权,让他们根据自己的地方处方优先事项调整应用程序,可能会提高它的成功程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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