Cluster randomized trials of prescription medicines or prescribing policy: public and general practitioner opinions in Scotland

Br J Clin Pharmacol. 2012 Aug;74(2):354-61. doi: 10.1111/j.1365-2125.2012.04195.x.

Abstract

Aims: To understand public and general practitioner (GP) opinion on the acceptability of randomized policy design (RPD) studies (cluster randomized trials) of prescription medicines in Scotland.

Methods: We surveyed public opinion on the concept of RPD studies in a sample of 1040 adults to determine acceptability and understand how people feel when changes are made to their medicines. We also surveyed GPs (n = 1034) about the concept of RPD studies as a tool for improving understanding of comparative effectiveness and safety of medicines in the 'usual care' setting.

Results: Thirty per cent of people would be happy to receive a letter about randomized policy changes to their therapy, 31% would not mind or had no opinion and 39% would be unhappy. This view was sensitive to the reason for change; effectiveness and safety reasons were most acceptable (96%) and cost saving least acceptable (39%). Only 19% thought randomized policy change was not an acceptable method of determining the best treatments. Eighty-one per cent of respondents were willing for their medical data to be followed up to compare drug treatments (further 10% undecided). Participants reporting long-term medical conditions and those reporting previous changes to drug therapy were more in favour of RPD studies than other participants. Thirty-three per cent (n = 341) of GPs responded to our survey. Of these, 45% were in favour of RPD studies, 19% were undecided and 36% not in favour.

Conclusions: The public in Scotland is broadly supportive of the concept of randomized policy design studies of medicines, while there is a spread of opinion among GPs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Cluster Analysis*
  • Cost Savings
  • Cost-Benefit Analysis
  • Drug Costs
  • Drug Prescriptions
  • Female
  • General Practitioners / psychology*
  • Health Knowledge, Attitudes, Practice*
  • Health Policy* / economics
  • Health Services Research
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Patient Safety
  • Prescription Drugs / adverse effects
  • Prescription Drugs / economics
  • Prescription Drugs / therapeutic use*
  • Public Opinion*
  • Randomized Controlled Trials as Topic / methods*
  • Research Design*
  • Scotland
  • State Medicine / economics
  • State Medicine / legislation & jurisprudence*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Prescription Drugs