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This qualitative study aims to examine key stakeholders' perspectives of primary care group/trust prescribing strategies. Within the context of general practice prescribing, the paper also debates the wider issue of whether GPs' prescribing autonomy is under threat from managerial expansion following recent organisational changes in primary care.

Data were obtained from focus groups and a series of individual semi‐structured interviews with GPs and key primary care organisation stakeholders.

The data underlie a tension between the managerial objective of cost‐restraint and GPs' commitment to quality improvement and individual clinical patient management. In presenting both managerial and medical narratives, two divergent and often conflicting discourses emerge, which leads to speculation that managerial attempts to constrain prescribing autonomy will achieve only limited success. The contention is that GPs' discourse features as a challenge to a managerial discourse that reflects attempts to regulate, standardise and curtail clinical discretion. This is due not only to GPs' expressed hegemonic ideals that clinical practice centres on the interests of the individual patient, but also to the fact that the managerial discourse of evidence‐based medicine encapsulates only a limited share of the knowledge that GPs draw on in decision making. However, while managers' discourse presented them as unwilling to impose change or directly challenge clinical practice, evidence also emerged to suggest that is not yet possible to be sufficiently convinced of the future retention of prescribing autonomy. On the other hand, the use of peer scrutiny posed an indirect managerial influence on prescribing, whilst the emergence of prescribing advisors as analysts of cost‐effectiveness may threaten doctors' dominance of medical knowledge.

There is a continuing need to analyse the impact of the new managerial reforms on primary care prescribing.

This study provides a snapshot of managerial and GP relations at a time of primary care transition.

Aims to show that audit and feedback could improve the prescribing of hormone replacement therapy (HRT) to women with a history of hysterectomy. Describes a randomised controlled trial involving 28 practices and covering a total of 3,169 women with a baseline coded history of hysterectomy. In addition to data extraction and feedback, intervention practices were given educational material and audit support. A rise in prescribing was evident in both younger and older women. There was also evidence of significant improvement in the appropriate prescribing of HRT. Concludes that prescribing feedback linked with educational material and audit can improve the prescribing of HRT in primary care in women with a history of hysterectomy and that this technique has wider application in the new era of clinical governance.

A social identity analysis, based on Hogg's (2000) uncertainty reduction theory, of the emergence and maintenance of ideological belief systems is presented. Uncertainty, particularly self-uncertainty, motivates identification with high-entitativity groups and behaviors that promote entitativity. Under more extreme uncertainty, identification is more pronounced and entitativity can be associated with orthodoxy, hierarchy and extremism, and with ideological belief systems. I develop and describe a social identity and uncertainty reduction analysis of ideology, and contextualize this in a brief discussion of the concept of ideology and in coverage of other contemporary social psychological treatments of ideology, such as social dominance theory, system justification theory, right-wing authoritarianism, belief in a just world, and the protestant work ethic.

This research examined fans' purchase intentions towards the sponsor of a NASCAR (National Association for Stock Car Auto Racing) event and towards the previous sponsor. The study shows that fans are more likely to purchase from the current sponsor and less likely to purchase from the previous sponsor. Fan identification and perceived group norms were significant predictors of purchase intentions towards the current sponsor, but only perceived group norms predicted purchase intentions towards the ex-sponsor. Additionally, perceived group norms partially mediated the relationship between fan identification and purchase intention.

Social prescribing is a model of integrated care, in which primary healthcare staff can link patients to the social care sector. However, social prescribing can occur in different forms. To better understand the concept of social prescribing, this literature review examines the role of the link workers, activities and target groups.

A literature review was conducted. Studies before May 2020 were considered. In total, 1,700 studies were identified using the databases Pubmed, PsycInfo, Cinahl, Web of Science and Cochrane Library. After eligibility checks, 16 studies were included in the final analysis.

A few studies warned of a deeper engagement of the link worker due to service dependency, but most studies encouraged an active and supportive role of the link worker. Participants engaged in social, physical and counseling activities. The majority of studies emphasized the importance of linking group activities with personal preferences and identity needs. The main target groups were composed of individuals with psychosocial needs, but some studies also included patients with physical or mental illnesses.

Social prescribing is widely advocated as an innovative model of integrated care. However, few studies have looked into the complex system of social prescribing. This study analyzes the linking processes, activities and target groups in extant social prescribing programs.

This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses.

This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs.

Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients.

Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.

Injectable opioid therapy (prescribing heroin for heroin addicts to inject) remains a highly controversial and expensive option. Recent research has shown significant benefits for this therapy in otherwise refractory patients. The aim of this paper is to assess the public opinion regarding heroin prescribing to addicts and to determine what effect the cost of this might have on their opinions.

Participants were asked to complete a questionnaire after reading a vignette which described current opioid maintenance therapy. Two vignettes were generated and the experimental group was randomised to receive the additional information that the cost of heroin prescribing was £15,000 per addict, per year.

Questionnaires were received from 187 subjects (response rate 74 percent). For the control group, 23 percent agreed and 58 percent disagreed with prescribing heroin to addicts (23 vs 62). For the experimental group, where the additional cost of £15,000 per addict was introduced into the vignette, 10 percent agreed and 75 percent disagreed (10 vs 71). The difference was statistically significant (p<0.05; χ²). In total, 58 percent of people were opposed to the idea that heroin should be prescribed to heroin addicts on the National Health Service but this rises to 75 percent when the annual cost of prescribed heroin (£15,000) is included.

This study supports an earlier survey that showed over 80 percent of the general public opposed the prescription of diamorphine to addicts even to reduce crime. Heroin prescribing remains controversial and lacks public support.

An understanding of the patterns of GP prescribing is important to those who play a role in the management of healthcare budgets. This paper analyses the contrasts and overlaps between the perceptions of healthcare managers and actual prescribing behaviour. While there are aspects of prescribing behaviour which are well understood, there are a number of areas where perceptions differ markedly from the patterns found in practice. The managerial implications of these differences are discussed.

The purpose of this paper is to examine the prescribed psychotropic medications taken by newly referred people with a range of substance use disorders (SUD) who attend a specialist community addiction service.

Anonymised data on newly referred people (n=1,537) with SUD attending a specialist community addiction service for their first episode of treatment between August 2007 and July 2010 were obtained from the database of the service. Data were cleaned and the percentage of people taking prescribed psychotropic medications at their first episode of treatment was calculated.

More than half (56.1 percent) of people attending the service were taking prescribed antidepressants and anxiolytics at their first episode of treatment whilst 15.2 percent of people were taking prescribed antipsychotics. Alcohol and opioids were the primary referral substances for 77.4 percent and 15.2 percent of people respectively. People referred for “other” substances (cannabis, stimulants, sedatives, hallucinogens, solvents and polydrug use) made up the remaining 7.5 percent and had the highest percentage of prescribed psychotropics (antipsychotics=47 percent, antidepressants and anxiolytics=64.3 percent) compared to those referred for alcohol and opioids (p<0.0005).

To the best of the authors’ knowledge, this is the first study of psychotropic prescribing among people with a range of SUD in the UK. The high prevalence of psychotropic prescribing raises questions about the appropriateness of these prescriptions and calls for scrutiny of prescribing practice in this group of people.

Addresses the issue of the adoption of generic drugs by general medical practitioners in the National Health Service in England. The adoption and buyer behaviour of GPs is of central importance to the pharmaceutical industry and to the Government. Reports research based on the theories of perceived risk and work simplification, set in the context of the growing pressure on doctors to contain total prescribing costs. Based on the findings of in‐depth research interviews with 39 GPs, concludes that perceived risk on the part of the GP is a significant determinant of generic drug adoption and that the desire to simplify work load decisions is also important.