Table 1

Studies investigating the perspectives of prescribers in various settings

Year of publicationLead authorCountryAimMedication typesParticipants and settingAge focus*Data collection methodAnalysis
1995BrittenEnglandTo identify patients whose current medication is the result of past treatment decisions and is regarded by their current GP as no longer appropriate, and to describe the drugs and the circumstances in which they continue to be prescribedMiscellaneous PIMs7 GPs, primary careAll agesDescriptive survey; GP selected patients prescribed inappropriate medicines, structured data extraction from notes and GP-facilitated interview of patientN/A
1997DybwadNorwayTo understand factors that could result in variations between GPs in order to form hypotheses and build theories about prescribing (main focus on factors that explain higher rates of prescribing)Benzodiazepines and minor opiates38 GPs (18 high rate prescribers, 20 medium to low rate prescribers), primary careAll agesSSIs (combined with prescription registration information)Not stated
1999DamestoyCanadaTo explore physicians’ perceptions and attitudes and the decision-making process associated with prescribing psychotropic medications for elderly patientsPsychotropics (sedatives, hypnotics, anxiolytics and antidepressants)9 physicians who conduct home visits, primary careOlder patients(Presumed face-to-face) SSIsGrounded theory analysis
2000CantrillEngland and ScotlandTo explore factors which may contribute to inappropriate long-term prescribing in UK general practiceMiscellaneous PIMs22 GPs, primary careAll agesFace-to-face and telephone interviews informed by specific examples of PIMs identified by validated indicatorsNot stated
2004IliffeEnglandTo explore beliefs and attitudes about continuing or stopping benzodiazepine hypnotics among older patients using such medicines, and among their GPsBenzodiazepines72 GPs, primary careOlder patientsNon-standardised interview group discussionsNot stated
2005SpinewineBelgiumTo explore the processes leading to inappropriate use of medicines for elderly patients admitted for acute careMiscellaneous PIMs3 geriatricians and 2 house officers, hospital elderly acute care wardsOlder patientsSSIs with health professionals triangulated with observation on wards and FGs with elderly inpatientsNot stated
2005RaghunathEnglandTo understand the prescribing behaviour of GPs by exploring their knowledge, understanding and attitudes towards PPIsPPIs49 GPs, primary careAll agesFocus groupsNot stated
2006ParrAustraliaTo gain a more detailed understanding of GP and benzodiazepine user perceptions relating to starting, continuing and stopping benzodiazepine useBenzodiazepines28 GPs, primary careAll agesSSIsNot stated
2007CookUSATo understand factors influencing the chronic use of benzodiazepines in older adultsBenzodiazepines33 primary care physiciansOlder patientsFace-to-face and telephone SSIsNarrative analysis
2007RogersEnglandTo explore the dilemma the controversial benzodiazepine legacy has created for recent practitioners and their view of prescribing benzodiazepinesBenzodiazepines22 GPs, primary careAll agesSSIsNot stated
2010AnthierensBelgiumTo describe GPs’ views and beliefs on polypharmacy in order to identify the role of the GP in improving prescribing behaviourPolypharmacy65 GPs, primary careOlder patientsFace-to-face individual SSIs (literature informed interview guide)Content analysis
2010DickinsonUKTo explore the attitudes of older patients and their GPs to chronic prescribing of antidepressant therapy, and factors influencing such prescribingAntidepressants10 GPs, primary careOlder patientsSSIsFramework analysis
2010FrichNorwayTo explore GPs’ and tutors’ experiences with peer group academic detailing, and to explore GPs’ reasons for deviating from recommended prescribing practiceMiscellaneous PIMs20 GPs (39 GPs also interviewed on topics outside the scope of this review)Older patientsFocus group interviews following individual receipt of prescription profile reportThematic content analysis
2010MoenSwedenTo explore GPs’ perspectives of treating older users of multiple medicinesPolypharmacy31 GPs (4 private, 27 county-employed), primary careOlder patientsFocus groups (literature informed question guide)Conventional content analysis
2010SubeljSloveniaTo investigate how high-prescribing family physicians explain their own prescriptionBenzodiazepines10 family physicians (5 high and 5 low prescribers), primary careAll agesSSIsNot stated
2011FriedUSATo explore clinicians’ perspectives of and experiences with therapeutic decision-making for older persons with multiple medical conditionsPolypharmacy36 physicians, primary care, vet affairs and academiaOlder patientsFocus groupsContent analysis
2011IdenNorwayTo explore decision-making among doctors and nurses on antidepressant treatment in nursing homesAntidepressants16 doctors, 8 each working full-time and part-time in residential aged care facilitiesOlder patientsFocus groupsSystematic text condensation and analysis
2012FlickGermanyTo explore, given the specific risks and the limited effect of sleeping medication, why doctors prescribe hypnotics for the elderly in long-term care settingsHypnotics20 prescribers servicing residential aged care facilitiesOlder patientsEpisodic interviewsThematic analysis
2012SchulingThe NetherlandsTo explore how experienced GPs feel about deprescribing medication in older patients with multimorbidity and to what extent they involve patients in these decisionsPolypharmacy29 GPs, primary careOlder patientsFocus groupsNot stated
2013ClyneIrelandTo evaluate GP perspectives on a pilot intervention (to reduce PIP in Irish primary care)Miscellaneous PIMs8 GPs in the focus group and 5 GPs for SSIs, primary careOlder patientsFocus group and SSIsThematic analysis
2013WermelingGermanyTo describe factors and motives associated with the inappropriate continuation of prescriptions of PPIs in primary carePPIs10 GPs (5 who frequently continue and 5 who frequently discontinue PPIs), primary careAll agesSSIsFramework analysis
  • *Age focus refers to the indicative age group of patients who were the focus of participant discussions, as suggested by the terms used in each article, which did not specify the exact age ranges.

  • GPs, general practitioners; PIMs, potentially inappropriate medications; PIP, potentially inappropriate prescribing; PPIs, proton pump inhibitors; SSIs, semi-structured interviews.