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Although there is evidence that the efforts of pharmaceutical marketing exert a positive and significant influence on physician prescription decisions, the specific mechanisms by which this impact occurs remain uncertain. To address this issue, this study aims to investigate whether the physician’s habit persistence may explain the relationship between marketing efforts such as brand attributes and drug promotion and prescribing behavior. This study also explores whether there was any significant difference between specialists and general practitioners (GPs) regarding the effect of brand attributes and drug promotion on physician’s habit persistence, which influences prescribing behavior.

A survey instrument was administered to physicians, encompassing specialists in a particular field and GPs who provide primary care services. A nonparametric partial least squares multigroup analysis was used to analyze 393 valid responses using partial least squares-structural equation modeling.

The results indicate that the decision to prescribe the drug may be affected by the physician’s habit persistence in the presence of vital brand attributes and drug promotion. The relationship between physician’s habit persistence and prescribing behavior is significant in GPs and specialist groups. The findings also reveal that brand attributes are the most influential and significant determinant of physician’s habit persistence in the GPs group. In addition, physician specialists are more aware of the influence of drug promotion initiatives than GPs. Furthermore, this study discovered that the relationship between drug promotion and physician’s habit persistence indicates a significant difference between specialists and GPs.

Although several marketing scholars discuss the factors influencing prescribing behavior, a few studies have shown the role of brand attributes and drug promotion and their effect on physician’s habit persistence. This study will specifically contribute by examining the mediating role of physician’s habit persistence between marketing efforts and prescribing behavior. In addition, so far, no studies have effectively made a comparative analysis across physicians regarding the effect of marketing efforts on physician’s habit persistence and prescribing behavior.

Due to the proliferation of generic medicines, pharmaceutical marketing has become increasingly competitive, and marketing executives are now focusing their attention on understanding the prescribing behaviour of physicians to enable them to devise marketing strategies that would put them at a superior business position relative to their competitors. Previous studies carried out either lack a sound theoretical foundation, or report contrasting results, making generalizations sketchy. Thus, a better understanding of attitude-prescribing axiom is needed. Underpinned by the theory of reasoned action (TRA), this study aims to empirically examine the factors that predict the prescribing behaviour of physicians.

A conceptual model was developed and tested on a sample of 355 respondents drawn from 76 private and 50 public hospitals in Sudan. The data set from the questionnaire survey included both general practitioners (N = 200) and specialists (N = 155). Primary data gathered were analysed using partial least squares structural equation modelling (PLS-SEM).

The findings reveal that the prescribing behaviour of physicians is positively influenced by the physician’s attitude towards direct marketing, personal selling, educational travel and public relations, but negatively influenced by gifts. Besides, the moderating effect of subjective norms showed no significant influence on the relationship between attitude and prescribing behaviour. However, gender seems to moderate the attitude towards health sector-related charity on prescribing behaviour and the attitude towards scientific conferences on prescribing behaviour.

The findings gathered from this study offers a significant contribution to the ongoing debate on the essential factors that influence the prescribing behaviour of physicians in the hospital setting.

By examining the essential factors that predict physicians’ prescribing behaviour, pharmaceutical companies can improve their understanding of physicians’ attitudes towards the pharmaceutical promotional tools. This is an aspect that is ill reflected in the literature.

The purpose of this paper is to examine reported literature on the influence of medical representatives (MRs) and other promotional tools on drug prescribing behaviour, and to assess whether this effect is different in developed and developing countries.

A survey of the literature was conducted across online databases from 2000 to 2016. Eligible studies addressed MRs and other promotion tools used to influence drug prescribing in developed and developing countries.

A total of 40 reviewed studies met the inclusion requirements. In total, 22 of the studies were conducted in developed countries and 18 in developing countries. Out of ten studies that examined the influence of MRs on drug prescribing in developed countries, eight found a positive influence, one found only moderate and one finds no influence. Analogous results were found in developing countries. Six out of ten studies on the influence of MRs conducted in developing countries found a positive effect, three found only moderate effects, while one finds no influence. The influence of promotion tools on prescribing varied in developed countries, five found positive influence, four reported a small effect and one found negative influence. In developing countries, the size of effect also varied, five studies found positive influence of promotion tools on drug prescribing behaviour, five found a negligible or small effect, and one found no association. However, marked differences were observed between two sectors. In the developed countries, MRs are valued as a source of information and can have an effect on prescribing, while it is unreliable in developing countries. Sample drugs are more generally seen as an important promotional tool for prescribing in developed countries than developing countries.

The results derived from this review are based on studies with varying methodological consistency. The review provides the crucial information that will be valuable to researchers working on comparative analysis of marketing efforts in developing and developed countries.

This paper is one of the few systematic reviews on the influence of MRs and other promotional tools on prescribing. It compares the influence of MRs and promotional efforts in both developed and developing countries.

The role of patient’s characteristics in the prescribing decision of physicians comprises two major constructs: drug request and expectations. The purpose of this paper was to examine the existing literature on patient characteristics and then explore the circumstances that reinforce the connection between patient characteristics (drug requests and expectations) and physician prescribing decision.

A survey of the literature was carried out across online databases from 1994 to 2015, and 25 reviewed articles were identified. The influence of patient factors on physician prescribing decisions was identified in the articles. A conceptual model to investigate the patient characteristics that influence physicians’ prescribing decision was the developed.

There have been numerous studies on the effect of patient characteristics on physician prescription decision. Some studies discovered patient’s request for drug and expectations strongly influence physicians’ prescribing decision, whereas others found only minor or no relation. To resolve this ambiguity, there is a need to precisely understand how patient factors affect prescribing decisions of physicians, under different contexts and conditions. This review contends that contextual variables – drug characteristics, drug cost/benefits ratio and physician habit persistence – are determining factors in this debate.

The study recommends further studies on the influence of each factor on physician prescribing behaviour and an evaluation of the proposed model and moderating variables.

This paper is the first significant step towards recognizing contextual variables that may moderate the relationship between a patient’s drug request and expectations and prescribing behaviour. This research contributes to resolving the debate on the ways patient factors affect prescribing behaviour.

The over-reliance on psychotropic medication for the management of patients with learning disabilities with behaviour that challenges is well documented.This paper aims to discuss the application of the methodology of clinical audit within community learning disability mental health services to adapt interventions including optimising prescribing practice and behavioural interventions aiming to reduce behaviour that challenges in people with learning disabilities.

Questionnaire-based review of documentation in electronic patient records, covering relevant audit standards in line with NICE and Royal College of Psychiatrists, was carried out in the North Essex Community Learning Disability Service, Hertfordshire Partnership NHS Foundation Trust. The audit included patients on the caseload of consultant psychiatrists.

The audit demonstrated that the prescribing of psychotropic medication was within BNF maximum limits for all patients, evidence of “consent” procedures was being followed in the majority, and there was some evidence of deprescribing attempts.Improvement was required in several areas e.g. undocumented off label prescribing in a significant proportion of patients. Objective measures to record the severity of behaviours and the effects of the medication were being used by clinicians in only a small proportion of patients. A significant proportion of patients have prescribed medication in the absence of appropriate psychological or environmental interventions.

As a result of the audit findings, the action plan made recommendations such as the development of a database for tracking the prescribing of psychotropic medicines and routine use of standardised measures. This action has been supported by the pharmacy team. Positive developments include a clinical psychologist taking on the role of leading the development of behavioural intervention strategies.

The purpose of this paper is to estimate whether health maintenance organizations (HMO) physicians are more price sensitive than non‐HMO physicians in their prescribing behavior of brand‐name substitutes.

The study uses physician level data and a set of 13 drugs for the years 1997‐2000 to estimate the price sensitivity of HMO and non‐HMO physicians. A two‐part model is used to measure the price elasticity of brand‐name prescribing for HMO physicians. The first part uses a logit model to examine the physician's choice to prescribe the same drug to all patients with the same medical condition, or whether physicians alternate prescriptions among brand‐name substitutes. The second part employs OLS to estimate the influence of managed care, i.e. HMOs, on physician price sensitivity.

The results suggest that HMO physicians are less likely than non‐HMO physicians to prescribe a common drug to all patients with a specific medical condition, but rather HMO physicians exhibit more diversified prescribing behavior. Correspondingly, HMO physicians are more price sensitive in prescribing brand‐name substitutes, than non‐HMO physicians, exhibiting price elasticities of prescribing ranging from −1.707 to −1.823. The analysis suggests that HMOs have a modest influence on encouraging physicians to be more price sensitive in their prescribing of brand‐name substitutes. HMO physicians are more price sensitive in their prescribing behavior than non‐HMO physicians.

This paper provides insight into the effectiveness of HMOs in altering physician prescribing behavior and price sensitivity of pharmaceutical prices. The results provide suggestions on how HMOs can improve the cost‐effectiveness of physician prescribing behavior.

The purpose of this paper is to examine the physicians’ attitude toward branded generic drugs in prescribing those drugs in some selective medical conditions and to identify the factors that influence physicians’ behavior toward prescribing branded generic drugs in the said selective medical conditions.

The study was carried out across six major cities in eastern India with 301 physicians. The current study introduced some significant elements into the modified technology acceptance model (TAM) with title the extended tam for product usage (TETPU) to analyze the prescribing factors that influence physicians in five common yet serious medical conditions in India. Out of nine factors considered here, seven were selected from the previous literature studies of different product segments and two were proposed by the authors. Demographic factor was proposed as the confounding variable.

The results indicated that apart from the factors “perceived no need” and “physicians’ perception and need achievement” rest of the factors showed satisfactory to excellent results.

The current study findings may enable the pharmaceutical managers to revise or modify their current marketing communication and other brand-building strategies so as to achieve a superior performance that offers them a competitive advantage.

The paper fulfils a need for advancing the knowledge on the physician’s prescription influencing factors by introducing the newer aspects of the concept and offers a theoretical framework for the academia and practical framework for the managers who desire to implement the strategies to achieve competitive advantage.

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for implementing clinical guidelines in primary care and thus influencing prescribing by general practitioners (GPs). A total of 25 semi‐structured interviews were conducted with GPs and primary care academics. To enrich the model an ongoing literature review of guideline implementation and changing prescribing behaviour was used. A simple model was derived to guide primary care organisations and GPs in implementing guidelines for prescribing, which comprises six steps: choose the condition; choose the guideline; identify influential people; identify organisational factors; plan and adopt an implementation strategy; and monitor the resulting adherence. The model provides a framework for planning the implementation of guidelines, and recognising barriers that hinder adherence to guidelines. It may help to explain why clinical guidelines vary in their uptake.

The programme – Stopping the over-medication of people with an intellectual disability, Autism or Both (STOMP) is a three-year programme supported by NHS England. Concern about the overuse of antipsychotic drugs has been a constant theme since the 1970s. However, despite a multitude of guidelines the practice continues. The report into the events at Winterbourne View not only raised concerns about the overuse of antipsychotic drugs but of antidepressants and multiple psychotropic drug use. The purpose of this paper is twofold: Part 1 is to present the history and background to the use of psychotropic drugs in intellectual disabilities, autism or both; and Part 2 presents the progress with the STOMP programme.

The review tracks the various concerns, guidelines and attempts to tackle the issue of over medication of people with intellectual disability autism or both.

The review identifies that despite the many studies and guidelines associated with the prescribing of psychotropic drugs for people with an intellectual disability, autism or both the practice is common. Programmes that minimise the use of psychotropic drugs involve a full use of the multidisciplinary team and an availability of alternative methods of managing challenging behaviours.

STOMP is part of an English national agenda – Transforming care. The English Government and leading organisations across the health and care system are committed to transforming care for people with intellectual disabilities, autism or both who have a mental illness or whose behaviour challenges services. This review identifies many studies, programmes and guidelines associated with psychotropic drug use for people with an intellectual disability, autism or both.

The purpose of this paper is to investigate the influence of direct-to-physician promotion on physicians’ prescription behaviour. There were very few studies which have investigated to what extent the pharmaceutical promotion directed towards physicians influences physicians’ prescription behaviour in the Malaysian context.

A research framework has been developed based on the buyer behaviour stimulus-response model. A survey method has been used to collect data from 154 medical practitioners from private health-care facilities located at Klang valley in Malaysia. IBM SPSS and SmartPLS statistical programs have been used to analyse the data and validate the model.

This study found that personal selling is the most significant promotional tool for physicians’ prescription behaviour, whereas advertising is the least significant one. Sales promotion and public relations are the second and third most significant promotional tools. Direct marketing is found to be not significant.

This paper will help the pharmaceutical companies develop more effective plans to gain a competitive advantage for their business by having a guideline for pharmaceutical marketers as an input to the more efficient allocation of their promotional budgets.

This study has introduced a comprehensive understanding of all the factors in the pharmaceutical promotion that influence physicians’ prescription behaviour in Malaysia and how these factors are interrelated, influencing physicians’ prescribing medicines for patients.