RAPID PRESCRIBING CHANCE, HOW DO PATIENTS RESPOND

The cost of prescribed medication is an increasing burden on health ca re systems. British general practitioners have been encouraged to redu ce their prescribing costs through financial incentives within the fun dholding scheme. This study reports on one general practice which redu ced prescribing expenditure as part of the move to fundholding. Interv iews performed with practice staff and patients were analysed and comb ined with prescribing statistics and questionnaire data to give a pict ure of the balance between the experience of patients and practitioner s. Fifty-three interviews with 17 patients revealed that most were wil ling to try cheaper treatments and that dissatisfaction was primarily with the communication they received lather than the change itself. Ea ch patient had to decide how to respond to the change in their medicat ion. The decision-making process and the main factors involved are des cribed and discussed. The experience of having long-standing treatment . changed can have ail impact on the hector-patient relationship. This was not found to be a large problem and, it is suggested, can be guar ded against. Large-scale economies in prescribing are feasible for som e practices, and patients will tolerate such changes if attention is p aid to sensitive communication. Copyright (C) 1996 Elsevier Science Lt d.