Factors influencing family physicians' drug prescribing behaviour in asthma management in primary care

Tan NC, Tay IH, Ngoh A, Tan M
Correspondence: Dr Tan Ngiap-Chuan, tan.ngiap.chuan@singhealth.com.sg

ABSTRACT
Introduction Little is known about the decision pathway that family physicians (FP) take in considering drug therapy for their asthma patients. This study aimed to explore the factors that influence FPs’ decisions in prescribing medications for their asthma patients.
Methods A qualitative method using focus group discussions (FGD) was used to gather qualitative data based on a semi-structured topic guide from FPs of different training backgrounds and practices. 29 Singapore FPs working as private general practitioners (GP), polyclinic doctors and locums were recruited into five FGDs.
Results The FPs’ asthma drug prescription decisions were related to the FPs’ medical training and acquisition of asthma-related information and updates. Uncertainty of disease diagnosis, patients’ beliefs and their perceptions of the disease and treatment, as well as the FPs’ concerns about drug side effects, were significant considerations for the participants. Costs related to differential subsidies in the consultation fees and drugs between public polyclinics and GP clinics in the local primary healthcare system, was a key factor in influencing the FPs’ asthma drug treatment decisions.
Conclusion FPs’ asthma drug prescribing behaviour is influenced by their medical training, disease definition, patient factors and drug costs in the context of the local primary healthcare system and policy.

Keywords: asthma, qualitative research, family physician, drug prescription
Singapore Med J 2009; 50(3): 312-319