NDLI: Surveillance of drug prescribing: why outliers miss their targets

Content Provider	Springer Nature : BioMed Central
Author	Gollnick, Julia Zeschick, Nikoletta Hörbrand, Franziska Killian, Peter Sebastiao, Maria Kühlein, Thomas Donner-Banzhoff, Norbert
Abstract	Background Rising costs are a challenge for healthcare systems. To keep expenditure for drugs under control, in many healthcare systems, drug prescribing is continuously monitored. The Bavarian Drug Agreement (German: Wirkstoffvereinbarung or WSV) for the ambulatory sector in Bavaria (the federal state of Germany) was developed for this purpose. Physicians must reach defined drug target quotas for prescribing generic drugs and certain recommended drugs specified and measured with defined daily doses (DDD). A subgroup of physicians, known as outliers, may miss their drug targets. The objective of this qualitative study was to understand the reasons physicians miss their targets. Methods We identified outliers based on drug prescribing data from the association of statutory health insurance (SHI)-accredited physicians (KV). Outliers were invited to participate in semi-structured interviews. Results Out of 401 outliers thus identified n = 26 physicians were interviewed. Their prescribing behaviours are affected by competing demands regarding drug decisions, such as saving staff time, costs, and discussions with patients. Often, their freedom to prescribe is limited by previous prescribers. Ease of administration of drugs not recommended also plays a role. Uncritical enthusiasm regarding the effectiveness and safety of drugs with recommendations, often reinforced by pharmaceutical marketing, leads to missed targets. Some physicians have coping strategies to avoid becoming outliers. Conclusions Investigating physicians not meeting their targets helps us understand beliefs and barriers for appropriate drug prescribing. Based on these kinds of findings, surveillance procedures can be improved, and physicians can receive support to meet targets in the future. Trial registration This trial has been registered in the German Register of Clinical Trials (DRKS: DRKS00016161; registration date 07. December 2018).
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-024-12189-0.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-024-12189-0
Journal	BMC Health Services Research
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-01-03
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Drug prescriptions Quality of health care/economics Qualitative research Drug costs Clinical decision-making
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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