New drug uptake: qualitative comparison of high and low prescribing GPs' attitudes and approach

Background. Prescribing varies considerably between GPs, and a minority of GPs account for a large proportion of new drug prescribing. Objective. Our aim was to explore the differences in approach and attitudes towards new drug prescribing between high and low GP prescribers. Methods. Semi-structured interviews were undertaken with 30 GPs who were either high or low prescribers of new drugs. Interview topics included reasons for prescribing new drugs; use of information sources; attitudes and approach to drug innovation; and consideration of the balance of risk and therapeutic benefit. Results. Differences in GPs' appraisal of new drugs enabled the development of a classification of attitudes and approaches applying to high and low prescribers. Difference in the behaviours of each group is a matter of degree of attitude or influence rather than (usually) its absence. Key dimensions in the classification are attitudes towards new drug prescribing, perception of risk and benefits, strategies adopted for risk management, information-seeking behaviour and use of the pharmaceutical industry as a significant information source. Conclusion. Variability in GP prescribing of new drugs relates not only to levels of acquired knowledge, but also to differences in subjective and ideological beliefs.