General practitioners' risk literacy and real-world prescribing of potentially hazardous drugs : a cross-sectional study
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: Overuse of medical care is a pervasive problem. Studies using hypothetical scenarios suggest that physicians' risk literacy influences medical decisions; real-world correlations, however, are lacking. We sought to determine the association between physicians' risk literacy and their real-world prescriptions of potentially hazardous drugs, accounting for conflicts of interest and perceptions of benefit-harm ratios in low-value prescribing scenarios.
SETTING AND SAMPLE: Cross-sectional study-conducted online between June and October 2023 via field panels of Sermo (Hamburg, Germany)-with a convenience sample of 304 English general practitioners (GPs).
METHODS: GPs' survey responses on their treatment-related risk literacy, conflicts of interest and perceptions of the benefit-harm ratio in low-value prescribing scenarios were matched to their UK National Health Service records of prescribing volumes for antibiotics, opioids, gabapentin and benzodiazepines and analysed for differences.
RESULTS: 204 GPs (67.1%) worked in practices with ≥6 practising GPs and 226 (76.0%) reported 10-39 years of experience. Compared with GPs demonstrating low risk literacy, GPs with high literacy prescribed fewer opioids (mean (M): 60.60 vs 43.88 prescribed volumes/1000 patients/6 months, p=0.016), less gabapentin (M: 23.84 vs 18.34 prescribed volumes/1000 patients/6 months, p=0.023), and fewer benzodiazepines (M: 17.23 vs 13.58 prescribed volumes/1000 patients/6 months, p=0.037), but comparable volumes of antibiotics (M: 48.84 vs 40.61 prescribed volumes/1000 patients/6 months, p=0.076). High-risk literacy was associated with lower conflicts of interest (ϕ = 0.12, p=0.031) and higher perception of harms outweighing benefits in low-value prescribing scenarios (p=0.007). Conflicts of interest and benefit-harm perceptions were not independently associated with prescribing behaviour (all ps >0.05).
CONCLUSIONS AND RELEVANCE: The observed association between GPs with higher risk literacy and the prescription of fewer hazardous drugs suggests the importance of risk literacy in enhancing patient safety and quality of care.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
BMJ quality & safety - (2024) vom: 17. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wegwarth, Odette [VerfasserIn] |
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| Links: |
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| Themen: |
Decision making |
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| Anmerkungen: |
Date Revised 17.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1136/bmjqs-2023-016979 |
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| 520 | |a © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: Overuse of medical care is a pervasive problem. Studies using hypothetical scenarios suggest that physicians' risk literacy influences medical decisions; real-world correlations, however, are lacking. We sought to determine the association between physicians' risk literacy and their real-world prescriptions of potentially hazardous drugs, accounting for conflicts of interest and perceptions of benefit-harm ratios in low-value prescribing scenarios | ||
| 520 | |a SETTING AND SAMPLE: Cross-sectional study-conducted online between June and October 2023 via field panels of Sermo (Hamburg, Germany)-with a convenience sample of 304 English general practitioners (GPs) | ||
| 520 | |a METHODS: GPs' survey responses on their treatment-related risk literacy, conflicts of interest and perceptions of the benefit-harm ratio in low-value prescribing scenarios were matched to their UK National Health Service records of prescribing volumes for antibiotics, opioids, gabapentin and benzodiazepines and analysed for differences | ||
| 520 | |a RESULTS: 204 GPs (67.1%) worked in practices with ≥6 practising GPs and 226 (76.0%) reported 10-39 years of experience. Compared with GPs demonstrating low risk literacy, GPs with high literacy prescribed fewer opioids (mean (M): 60.60 vs 43.88 prescribed volumes/1000 patients/6 months, p=0.016), less gabapentin (M: 23.84 vs 18.34 prescribed volumes/1000 patients/6 months, p=0.023), and fewer benzodiazepines (M: 17.23 vs 13.58 prescribed volumes/1000 patients/6 months, p=0.037), but comparable volumes of antibiotics (M: 48.84 vs 40.61 prescribed volumes/1000 patients/6 months, p=0.076). High-risk literacy was associated with lower conflicts of interest (ϕ = 0.12, p=0.031) and higher perception of harms outweighing benefits in low-value prescribing scenarios (p=0.007). Conflicts of interest and benefit-harm perceptions were not independently associated with prescribing behaviour (all ps >0.05) | ||
| 520 | |a CONCLUSIONS AND RELEVANCE: The observed association between GPs with higher risk literacy and the prescription of fewer hazardous drugs suggests the importance of risk literacy in enhancing patient safety and quality of care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Decision making | |
| 650 | 4 | |a Evidence-based medicine | |
| 650 | 4 | |a Healthcare quality improvement | |
| 650 | 4 | |a Medical education | |
| 650 | 4 | |a Patient safety | |
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| 700 | 1 | |a Goldacre, Ben |e verfasserin |4 aut | |
| 700 | 1 | |a Spies, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a Giese, Helge A |e verfasserin |4 aut | |
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