Abstract
BackgroundPrimary care physicians are gate keepers to the medical system having a key role in giving information and prescribing drugs to their patients. In this respect they are involved in claims of patients/clients for pharmacological Cognitive Enhancement (CE). Therefore, we studied the knowledge of primary care physicians about CE and their attitudes toward prescribing CE drugs to healthy subjects.MethodsA self-report paper-and-pencil questionnaire and case vignettes describing a hypothetical CE drug were sent out to all 2,753 registered primary care physicians in Rhineland Palatine, Germany. 832, i.e. 30.2% filled in the questionnaire anonymously.Results96.0% of all participating physicians had already heard about CE. However, only 5.3% stated to be very familiar with this subject and 43.5% judged themselves as being not familiar with CE. 7.0% had been asked by their clients to prescribe a drug for CE during the last week, 19.0% during the last month, and 40.8% during the last year. The comfort level to prescribe CE drugs was very low and significantly lower than to prescribe sildenafil (Viagra®). Comfort level was mainly affected by the age of the client asking for prescription of CE drugs, followed by the availability of non-pharmacological alternatives, fear of misuse of the prescribed drug by the client and the missing indication of prescribing a drug.ConclusionsAlthough a relatively high proportion of primary care physicians have been asked by their clients to prescribe CE drugs, only a small proportion are well informed about the possibilities of CE. Since physicians are gate keepers to the medical system and have a key role regarding a drugs’ prescription, objective information should be made available to physicians about biological, ethical and social consequences of CE use.
Highlights
Primary care physicians are gate keepers to the medical system having a key role in giving information and prescribing drugs to their patients
This survey among a random sample of 1,500 practicing physicians from the American Medical Association (AMA) Masterfile found that 37.0% of the participants stated that they prescribed what they viewed as medicine for enhancement at least monthly and 4.0% at least daily [2]
Using the Randomized Response Technique (RRT) which guarantees an especially high degree of privacy, anonymity, and confidentiality, we found in German students a one-year prevalence rate of 20.0% for the use of “pharmaceuticals or illegal drugs which you cannot buy in a drug-store and which were not prescribed to you to treat a disease”. [11]
Summary
Primary care physicians are gate keepers to the medical system having a key role in giving information and prescribing drugs to their patients. With particular reference to the phenomenon of pharmacological cognitive enhancement (CE), Hotze and colleagues found that two thirds of surveyed primary care physicians received requests for “medicine or services that the physicians considered to be for enhancement rather than therapy” monthly and 12.0% at least daily This survey among a random sample of 1,500 practicing physicians from the American Medical Association (AMA) Masterfile found that 37.0% of the participants stated that they prescribed what they viewed as medicine for enhancement at least monthly and 4.0% at least daily [2]
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