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Rationale behind psychiatrists' choice of drug

Withington Hospital, Nell Lane, West Didsbury, Manchester M20 8LR

Aims and method The study investigated the reasons that influence medical staffs' choice of a specific drug over another given the same clinical situation, by use of a questionnaire-based survey. The study population was 88 clinicians of various ranks, at psychiatry units in National Health Service university and district general hospitals in Greater Manchester. Responses in the factors: personal experience, scientific evidence, influence from colleagues, economic consideration, influence by drug representatives, ward or unit policy and other in choice of prescription, were the main outcome measures.

Results Of the 546 responses generated by the 88 clinicians, 263 (48.2%) were for personal experience as the most important influence on choice of prescription. Scientific evidence was the second most important factor with 117 (21.4%) responses. Economic consideration and influence by drug representatives were least important. This trend held for all ranks except for registrars, where scientific evidence was as important as personal experience.

Clinical implications As prescribers, clinicians trust mostly in their own personal experience. This may not be unique to psychiatrists. An understanding of how clinicians gain ‘personal experience’ could be important in improving rational prescribing.

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