Abstract
BackgroundIrrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. Recent findings from a research project funded by the European Commission (FP7), the “OTC SOCIOMED”, conducted in seven European countries, indicate that physicians in countries in the Mediterranean Europe region prescribe medicines to a higher degree in comparison to physicians in other participating European countries. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region.MethodsThis feasibility study utilized an educational intervention was designed using the Theory of Planned Behaviour (TPB). It took place in geographically-defined primary care areas in Cyprus, France, Greece, Malta, and Turkey. General Practitioners (GPs) were recruited in each country and randomly assigned into two study groups in each of the participating countries. The intervention included a one-day intensive training programme, a poster presentation, and regular visits of trained professionals to the workplaces of participants. Reminder messages and email messages were, also, sent to participants over a 4-week period. A pre- and post-test evaluation study design with quantitative and qualitative data was employed. The primary outcome of this feasibility pilot intervention was to reduce GPs’ intention to provide medicines following the educational intervention, and its secondary outcomes included a reduction of prescribed medicines following the intervention, as well as an assessment of its practicality and acceptance by the participating GPs.ResultsMedian intention scores in the intervention groups were reduced, following the educational intervention, in comparison to the control group. Descriptive analysis of related questions indicated a high overall acceptance and perceived practicality of the intervention programme by GPs, with median scores above 5 on a 7-point Likert scale.ConclusionsEvidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions. In addition, it could also help inform health policy makers and decision makers regarding the management of behavioural changes in the prescribing patterns of physicians in Mediterranean Europe, particularly in Southern European countries.
Highlights
Irrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe
Evidence from this intervention will estimate the parameters required to design a larger study aimed at assessing the effectiveness of such educational interventions
Primary health care centres that deliver their services on a 24-hour basis, jointly with their peripheral posts, seem to be the predominant model in rural areas in Malta, Greece, and Cyprus; whilst this is a fact based on empirical evidence, the number of General Practitioner (GP) who work in solo practice and serve the private sector appears to be increasing in these countries
Summary
Irrational prescribing of over-the-counter (OTC) medicines in general practice is common in Southern Europe. In light of these findings, a feasibility study has been designed to explore the acceptance of a pilot educational intervention targeting physicians in general practice in various settings in the Mediterranean Europe region. The use of OTC medicines is steadily rising, [5] and concerns about inappropriate treatment and adverse medicine reactions have been raised, [6] this subject does not appear to have received the attention it deserves in general practice research, resulting in a serious evidence gap, in Europe [7,8]
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