Characteristics of decision-making process during prescribing in general practice

Background/Aim. The process of prescribing decision-making by general practitioners requires numerous consultations in order to obtain maximal effects, minimal risks, and cost-effectiveness with the full appreciation of a patient's right to choose. The aim of our study was to describe the proce...

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Main Authors: Đorđević Nataša D., Janković Slobodan M.
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2006-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500603279D.pdf
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author Đorđević Nataša D.
Janković Slobodan M.
author_facet Đorđević Nataša D.
Janković Slobodan M.
author_sort Đorđević Nataša D.
collection DOAJ
description Background/Aim. The process of prescribing decision-making by general practitioners requires numerous consultations in order to obtain maximal effects, minimal risks, and cost-effectiveness with the full appreciation of a patient's right to choose. The aim of our study was to describe the process of decision-making by general practitioners who decide on the treatment for an individual patient, and to relate the scope and nature of this process to the quality of the outcome of the decision. Methods. The study involved 53 general practitioners who worked in the Health Center, Kragujevac at the time of investigation (September-December 2002.). General practitioners made prescribing decisions, thinking aloud, for five patients with urinary tract infections (n = 2), or stomach complaints (n = 3). The resulting 265 transcripts were analyzed to determine the scope and nature of the decision-making processes. Differences in prescribing were related to the case or the practitioners′ working experience, and to their educational background. Results. Our results showed that the more years of practice the practitioners had the less treatments they prescribed, and the less additional aspects before prescribing they considered. The doctors with less experience, in most of the cases, considered the core aspects, while those with more experience more often considered the contextual and habitual aspects. Educational background of the general practitioners, and the type of a considered disease, had an influence on the decision-making process. The most optimal method for decision-making (marked as type F) was mostly used by the practitioners with the least experience, while the those with more experience mainly made their decisions in the ways considered the least acceptable. The optimal method for decision-making process does not necessarily provide the optimal therapy, so the least acceptable decision-making might not result in an inappropriate treatment. Conclusions. The observed prescribing decisions were mostly in disagreement with the Good Clinical Practice. Our study pointed out the need for the obligatory continuation of medical education of general practitioners in decision-making process during prescribing.
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spelling doaj-art-bc846063b9f8458ab24cf4aba73616372025-08-20T03:04:57ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502006-01-0163327928510.2298/VSP0603279DCharacteristics of decision-making process during prescribing in general practiceĐorđević Nataša D.Janković Slobodan M.Background/Aim. The process of prescribing decision-making by general practitioners requires numerous consultations in order to obtain maximal effects, minimal risks, and cost-effectiveness with the full appreciation of a patient's right to choose. The aim of our study was to describe the process of decision-making by general practitioners who decide on the treatment for an individual patient, and to relate the scope and nature of this process to the quality of the outcome of the decision. Methods. The study involved 53 general practitioners who worked in the Health Center, Kragujevac at the time of investigation (September-December 2002.). General practitioners made prescribing decisions, thinking aloud, for five patients with urinary tract infections (n = 2), or stomach complaints (n = 3). The resulting 265 transcripts were analyzed to determine the scope and nature of the decision-making processes. Differences in prescribing were related to the case or the practitioners′ working experience, and to their educational background. Results. Our results showed that the more years of practice the practitioners had the less treatments they prescribed, and the less additional aspects before prescribing they considered. The doctors with less experience, in most of the cases, considered the core aspects, while those with more experience more often considered the contextual and habitual aspects. Educational background of the general practitioners, and the type of a considered disease, had an influence on the decision-making process. The most optimal method for decision-making (marked as type F) was mostly used by the practitioners with the least experience, while the those with more experience mainly made their decisions in the ways considered the least acceptable. The optimal method for decision-making process does not necessarily provide the optimal therapy, so the least acceptable decision-making might not result in an inappropriate treatment. Conclusions. The observed prescribing decisions were mostly in disagreement with the Good Clinical Practice. Our study pointed out the need for the obligatory continuation of medical education of general practitioners in decision-making process during prescribing.http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500603279D.pdfdecision makingphysiciansfamilydrug therapyprescriptionsdrugeducationmedicalcontinuingphysician's practice patterns
spellingShingle Đorđević Nataša D.
Janković Slobodan M.
Characteristics of decision-making process during prescribing in general practice
Vojnosanitetski Pregled
decision making
physicians
family
drug therapy
prescriptions
drug
education
medical
continuing
physician's practice patterns
title Characteristics of decision-making process during prescribing in general practice
title_full Characteristics of decision-making process during prescribing in general practice
title_fullStr Characteristics of decision-making process during prescribing in general practice
title_full_unstemmed Characteristics of decision-making process during prescribing in general practice
title_short Characteristics of decision-making process during prescribing in general practice
title_sort characteristics of decision making process during prescribing in general practice
topic decision making
physicians
family
drug therapy
prescriptions
drug
education
medical
continuing
physician's practice patterns
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2006/0042-84500603279D.pdf
work_keys_str_mv AT đorđevicnatasad characteristicsofdecisionmakingprocessduringprescribingingeneralpractice
AT jankovicslobodanm characteristicsofdecisionmakingprocessduringprescribingingeneralpractice