DOES KNOWLEDGE OF DRUG PRESCRIBING PREDICT DRUG MANAGEMENT OF STANDARDIZED PATIENTS IN OFFICE PRACTICE

Drug prescribing for the elderly is an important area of medical knowl edge since inappropriate prescribing may lead to significant adverse d rug events. The objective of this study was to evaluate the associatio n between knowledge of drug use and quality of drug management by gene ral practitioners in practice. A cross-sectional study design was used to evaluate a sample of 37 GPs in practice. A set of common musculosk eletal problems was chosen to evaluate doctors' knowledge of non-stero idal anti-inflammatory drug use, while performance in practice was ass essed using elderly standardized patients. The reliability of knowledg e test scores was evaluated using measures of internal consistency. Th e relationship between knowledge of drug use and quality of therapeuti c management in practice was evaluated by rank order and linear correl ation analysis. Demographic characteristics of participating and non-p articipating doctors were similar. The reliability of the knowledge te st was 0.55. The reliability of performance scores was 0.66. The corre lation between overall performance on the standardized patient cases a nd total knowledge test score was 0.22 (95% confidence interval = 0-0. 63). Knowledge test scores were poorly correlated with quality of ther apeutic management in office practice. This indicates that knowledge t ests alone cannot predict quality of performance with regard to drug p rescribing for the elderly in primary care office practice.