P02-215 Physician-related factors that determine clinical decisions in Serbian psychiatry

Abstract

In this study, we made an attempt to identify the physician-related factors that determine the choice of drugs in Serbian psychiatric practice.The study was conducted at two major teaching psychiatric hospitals in Serbia. The structured questionnaire was used, and 41 psychiatrists were interwieved.Physicians cited approximately four (of eight offered) categories of factors that determine the choice of drugs. Most often, these categories were: safety (adverse effects) (78%), proven efficacy of the drug (73%), recommendations of the relevant guidelines (65%), and reimbursement of the treatment costs by the mandatory health insurance (46%). About 65% of psychiatrists stated that they adhere to the national, or (where there are not national), relevant international therapeutic guidelines. When asked to cite which international or foreign guidelines in particular they used, approximately 50% failed to do so. The other half cited mostly the American Psychiatric Association (APA) Guidelines or National Institute for Health Care and Clinical Excellence (NICE) Guidelines.The majority of the Serbian psychiatrists rely on the efficacy and safety of the drugs as major determining factors in the choice of therapy. However, substantial percentage of psychiatrists obtain indicators on drugs’ efficacy and safety from their personal professional experience. It is doubtful whether these indicators are valid, or just represent unproven prescribers’ habits. The majority of psychiatrists are willing to accept the relevant guidelines, and the effort should be made on the national level to further develop those guidelines and implement them into everyday practice.