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Influence of Patient Race on Physician Prescribing Decisions: A Randomized On-Line Experiment
Journal of General Internal Medicine, 08/27/09

Rathore SS et al. – Racial differences in outpatient prescribing patterns for hypertension, hypercholesterolemia, and diabetes are likely attributable to factors other than prescribing decisions based on patient race.

• Web–based survey including three clinical vignettes (hypercholesterolemia, hypertension, diabetes), with patient race (black, white) randomized across vignettes.
• A total of 716 respondents from 5,141 eligible sampled primary care physicians (14% response rate).
• Measurements: Medication recommendation (any medication vs none, on–patent branded vs generic, and therapeutic class) and physicians’ treatment adherence forecast (10–point Likert scale, 1—definitely not adhere, 10—definitely adhere).

• Patient race influenced medication class chosen in the hypertension vignette; respondents randomized to view black patients recommended calcium channel blockers more often (20.8% black vs 3.2% white) and angiotensin–converting enzyme inhibitors less often (47.4% black vs 62.6% white).
• Patient race did not influence medication class for hypercholesterolemia or diabetes.
• Respondents randomized to view black patients reported lower forecasted patient adherence for hypertension and diabetes, but race had no meaningful influence on forecasted adherence for hypercholesterolemia.

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