Introduction: Prescribing represents a fundamental component of patient care. Rational prescribin... more Introduction: Prescribing represents a fundamental component of patient care. Rational prescribing is crucial for patients' health and the health system. However, globally irrational prescribing is common and has a negative impact on clinical outcomes and the efficiency of health system. On the other hand, prescribing patterns determine the volume of pharmaceutical consumption and consequently pharmaceutical expenditure. However, in Greece there are only limited research evidence from specific health centers and there are no sufficient data neither for GPs' prescribing patterns in primary health care, nor for their beliefs regarding prescribing. Objectives: The aim of the present study was to record prescribing patterns of GPs and identify the specific prescribing circumstances in primary health care in Greece compared to other European countries. Furthermore, the present study aimed at identifying GPs' beliefs regarding prescribing.Methods: For this purpose a combinatio...
The aim of this paper is to explore general practitioners&amp... more The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.
To assess the effects of abolishing coinsurance for oral antihyperglycemic agents (OAAs) on the s... more To assess the effects of abolishing coinsurance for oral antihyperglycemic agents (OAAs) on the social insurance fund budget in Greece. A mathematical model estimating the effect of a decrease in patient coinsurance rate on demand for and adherence to OAAs and the subsequent clinical and economic outcomes. Price elasticity of demand for antidiabetic agents was used to estimate quantity demand change as a result of a coinsurance rate decrease and consequent increased adherence to OAAs. Given the inverse relationship between OAA adherence and glycated hemoglobin (A1C) level, the model calculated the mean decrease in A1C level and associated cost savings based on the cost difference between patients with controlled versus uncontrolled A1C levels. A decrease in patient coinsurance rate from 25% to 0% led to an incremental increase in OAA adherence of 30.5% and a mean decrease in A1C level of 0.6%. The A1C level decrease contributed to an 18.5% "shift" of uncontrolled patients ...
Introduction: Prescribing represents a fundamental component of patient care. Rational prescribin... more Introduction: Prescribing represents a fundamental component of patient care. Rational prescribing is crucial for patients' health and the health system. However, globally irrational prescribing is common and has a negative impact on clinical outcomes and the efficiency of health system. On the other hand, prescribing patterns determine the volume of pharmaceutical consumption and consequently pharmaceutical expenditure. However, in Greece there are only limited research evidence from specific health centers and there are no sufficient data neither for GPs' prescribing patterns in primary health care, nor for their beliefs regarding prescribing. Objectives: The aim of the present study was to record prescribing patterns of GPs and identify the specific prescribing circumstances in primary health care in Greece compared to other European countries. Furthermore, the present study aimed at identifying GPs' beliefs regarding prescribing.Methods: For this purpose a combinatio...
The aim of this paper is to explore general practitioners&amp... more The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.
To assess the effects of abolishing coinsurance for oral antihyperglycemic agents (OAAs) on the s... more To assess the effects of abolishing coinsurance for oral antihyperglycemic agents (OAAs) on the social insurance fund budget in Greece. A mathematical model estimating the effect of a decrease in patient coinsurance rate on demand for and adherence to OAAs and the subsequent clinical and economic outcomes. Price elasticity of demand for antidiabetic agents was used to estimate quantity demand change as a result of a coinsurance rate decrease and consequent increased adherence to OAAs. Given the inverse relationship between OAA adherence and glycated hemoglobin (A1C) level, the model calculated the mean decrease in A1C level and associated cost savings based on the cost difference between patients with controlled versus uncontrolled A1C levels. A decrease in patient coinsurance rate from 25% to 0% led to an incremental increase in OAA adherence of 30.5% and a mean decrease in A1C level of 0.6%. The A1C level decrease contributed to an 18.5% "shift" of uncontrolled patients ...
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