The role of the hospital consultant in general practitioner prescribing.

A questionnaire was designed and posted to 600 general medical practitioners in the West Midlands. The results indicated that the prescribers were reassured by the hospital consultant although independence was maintained in prescribing decisions. The hospital medical team was recognized for its expertise rather than the consultant alone. A table was constructed from the results to show the therapy areas in which doctors prefer to refer their patients. Consultant's influence in prescribing is most likely where communication between GP and consultant is optimal. The generalized influence of the consultant as implied by the Greenfield report remains unproven. Any influence is much more specific and may depend upon therapy area, the consultant specialty, and the standing of the hospital medical team. The innovativeness of the prescriber which was also considered may also have an influence as to how the consultant's recommendations will be accepted.

Hospital consultants--an influence on G.P. prescribing? A pilot study.

Ten thousand National Health Service prescriptions for drugs used in rheumatology, written by 300 general medical practitioners within one Area Health Authority area during one month were analysed. Thirty-six different preparations were prescribed. The prescriptions of three consultants in rheumatology from before the sample period were also analysed. Prescribing patterns were compared, in particular between G.P.s and the consultant to whom the G.P. usually referred his 'rheumatology' patients. Although the correlation coefficients between each consultant and each doctor-group studied were not found to be significant at the 5% level, implying little if any influence by the consultant on the prescribing of these G.P.s, a number of interesting features were noted which seem worthy of further study.

Identification and characterization of early and late prescribers in general practice.

National Health Service prescriptions written by general medical practitioners in one urban Area were analysed over a fifteen-month period to classify doctors into those who prescribed a named drug early or relatively later in its market life. A questionnaire, designed to answer a number of hypotheses intended to characterize these groups of practitioners, was mailed to the 100 doctors in each group. Statistical analysis of the results suggests that there are several identifiable characteristic differences between `early' and `late' prescribers. Early prescribers have larger list sizes than late prescribers and rely more on industrial sources for information about drugs.

Usage of information sources by general practitioners.

Questionnaires were sent to approximately 500 general practioners in five areas of one National Health Service Region; there was a 52% response. Certain characteristics of each general practitioner, which were collected from the questionnaire and medical lists, were used to assess how information was used by different `types' of general practitioner. Generally, sources of information emanating from the pharmaceutical industry are used more to introduce the new product, while the `professional' sources such as medical journals are used more to evaluate it. Younger doctors used Drug and Therapeutics Bulletin more than did their colleagues, and single-practice doctors found the representative to be more useful than did joint-practice doctors.

The effects of antacids on enteric-coated salicylate preparations.

A volunteer study was undertaken in which the effect of the co-administration of therapeutic doses of aluminium hydroxide and magnesium trisilicate on the excretion of aspirin derived from enteric-coated preparations was studied. A significant alteration in the pattern of salicylate excretion was seen, but the mechanism of the interaction cannot be deduced from the present study. It was concluded that the interaction was of potential therapeutic importance, and further studies based on this pilot investigation have been initiated.