JDrug Prescribing The Prescribing Habits of Resident Physicians are Monitored And the method of patient payment is found to have a significant effect .

In this study the prescribing habits of physicians in a family practice residency office. were examined . retrospectively. Data were collected over a 2.5-month period from a total of 1109 prescnptlo.ns to determine trends in the prescribing .of individual drugs and classes of drugs, the Influence on prescribing of the . physicians' level of training, and prescription numbers per visit in rela.tion to. one of three metho~s of patl~nt payment (Medicare-Medicaid, self-pay, third-party insurance). All physlcla~s In the practice were Involved In the study, although none knew that his prescribing habits would be mOnttored at a later date.

Those drug classes most often prescribed were antibacterials, antihistamine-decongestants and antihypertensives while psychotropic medicines were prescribed relatively less often. The data on drug use

are consistent with the patient problems encountered at the office during the study period. Apart from routine medical examinations, the most common disorders were acute upper respiratory tract infections, uncomplicated hypertension, vaginitis and urinary tract infections.

Prescription rates varied according to the year of residency of the physician with an average prescription number/visit for first-, second- and third-year residents of 0.59, 0.69, and 0.72, respectively. Faculty members rated a higher average of 0.98/patient visit, compared with an overall office average of 0.70.

Method of payment affected prescription numbers with those on Medicare-Medicaid averaging 0.78, self­pay patients 0.25 and third-party insurance patients 1.49 prescriptions/visit. On analysis, these differences were found to be significant.

The Medicare-Medicaid patients visited the office most frequently (45.3% of the total office visits) and also accounted for most of the prescriptions written (49.9%). Visits to the office by self-pay patients represented 37.4% of the total, but they only received 13.4% of the prescriptions written. On the other hand, third-party insurance patients accounted for 17.3% of the office visits and 36.6% of the prescriptions written. Thus, insurance schemes appear to have affected these prescribing rates, but other variables such as the severity of the patient's illness were not considered in this study. Further studies are needed. Jackson, MG.. Drechsler-Martell, GR. and Jackson, EA.' Drug Intelligence and Clinical Pharmacy 19: 205-209 (Mar 1985)

0156-2703/85/0323-0007/0$01.00/0 © ADIS Press INPHARMA® 23 Mar 1985 7