ArticleBMC health services research2025
Surveillance of drug prescribing: why outliers miss their targets - a qualitative study.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Prescribing Vitamin-K-Antagonists Versus Direct Oral Anticoagulants Among Bavarian General Practitioners: A Qualitative Study.Health services insights · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundRising costs are a challenge for healthcare systems. To keep expenditure for drugs under control, in many healthcare systems, drug prescribing is continuously monitored. The Bavarian Drug Agreement (German: Wirkstoffvereinbarung or WSV) for the ambulatory sector in Bavaria (the federal state of Germany) was developed for this purpose. Physicians must reach defined drug target quotas for prescribing generic drugs and certain recommended drugs specified and measured with defined daily doses (DDD). A subgroup of physicians, known as outliers, may miss their drug targets. The objective of this qualitative study was to understand the reasons physicians miss their targets.
methodsWe identified outliers based on drug prescribing data from the association of statutory health insurance (SHI)-accredited physicians (KV). Outliers were invited to participate in semi-structured interviews.
resultsOut of 401 outliers thus identified n = 26 physicians were interviewed. Their prescribing behaviours are affected by competing demands regarding drug decisions, such as saving staff time, costs, and discussions with patients. Often, their freedom to prescribe is limited by previous prescribers. Ease of administration of drugs not recommended also plays a role. Uncritical enthusiasm regarding the effectiveness and safety of drugs with recommendations, often reinforced by pharmaceutical marketing, leads to missed targets. Some physicians have coping strategies to avoid becoming outliers.
conclusionsInvestigating physicians not meeting their targets helps us understand beliefs and barriers for appropriate drug prescribing. Based on these kinds of findings, surveillance procedures can be improved, and physicians can receive support to meet targets in the future.
trial registrationThis trial has been registered in the German Register of Clinical Trials (DRKS: DRKS00016161; registration date 07. December 2018).
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