The impact of economic information on medical decision making in primary care

BACKGROUND: Many general practitioners (GPs) are concerned about the increasing dominance of economic issues in major decisions about clinical care, and feel their opinions on economic matters have not been heard. It is unclear whether this information has any impact on everyday clinical practice in a primary care setting. AIM: To investigate GPs' perspectives on the use of economic information in medical decision making. DESIGN OF STUDY: Cross-sectional survey. SETTING: GP members of the West of Scotland Primary Care Research and Development Network (WestNet). METHODS: Questionnaire survey sent to GPs by post and by email. RESULTS: The overall response rate was 44%, favouring postal over email responses. All respondents indicated that economic information has previously influenced them and should be incorporated into their medical decision making. The most common source of this information was generated by local authorities such as health boards, primary care groups and local prescribing advisors--used by 80% of the respondents. However, publications, such as the British Journal of General Practice, locally produced newsletters and prescribing formularies, and feedback from the General Practice Administration System for Scotland, were used as sources of economic information by 20%, 27% and 33%, respectively. Published materials--in particular, locally specific information and summarized information in leaflet format--were favoured (54%) in comparison to verbally presented material. CONCLUSIONS: GPs believe that economic information should be incorporated in medical decision making. The need for precise and summarized information, produced locally, has been highlighted. Better understanding towards the type of economic evidence GPs find useful and comprehensible is required.