PA Medical News about physician prescribing decisions; patient race

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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.

Methods

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).

Results

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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