Prescribing new drugs: qualitative study of influences on consultants and general practitioners

Objective To explore consultants' and general practitioners' perceptions of the factors that influence their decisions to introduce new drugs into the ir clinical practice. Design Qualitative study using semistructured interviews. Monitoring of hos pital and general practice prescribing data for eight new drugs. Setting Teaching hospital and nearby general hospital plus general practice s in Birmingham. Participants 38 consultants and 56 general practitioners who regularly refe rred to the teaching hospital. Main outcome measures Reasons for prescribing a new drug; sources of inform ation used for new drugs; extent of contact between consultants and general practitioners; and amount of study drugs used in hospitals and by general practitioners. Results Consultants usually prescribed new drugs only in their specialty, u sed few new drugs, and used scientific evidence to inform their decisions. General practitioners generally prescribed more new drugs and for a wider r ange of conditions, but their approach varied considerably both between gen eral practitioners and between drugs for the same general practitioner. Dru g company representatives were an important source of in-formation for gene ral practitioners. Prescribing data were consistent with statements made by respondents. Conclusions The factors influencing the introduction of new drugs, particul arly in primary care, are more multiple and complex than suggested by early theories of drug innovation. Early experience of using a new drug seems to strongly influence future use.