Prescribers’ perspectives of the socioeconomic status and important indicators affecting prescribing behavior in a developing country
Open accessAbstract
Patients suffer differential prescribing behavior as a function of their socioeconomic status. The current study was conducted in a qualitative and two observational phases in Lahore metropolitan area to investigate physician’s perspectives of patients’ socioeconomic status and the important indicators influencing prescribing behavior. Semi-structured interviews were conducted with physicians (N=20) from 2 hospitals, 2 diabetes care centers and 2 private clinics and scripts were analyzed for socioeconomic indicators. In the second phase, the opinions of a panel of prescribers (N=43) on the influence socioeconomic indicators on prescribing behavior were elicited. In the third phase a bipolar 5-point Likert rating scale was used to elicit the importance of indicators for physicians (N=100) originated from urban and rural areas. In the interviews physicians gave 15 potential socioeconomic indicators. Following the two Delphi rounds, consensus was reached on 11 (73.3%) of the indicators, the remaining 4 (26.7%) were highly disputable. Bivariate analysis showed that literacy, educational background, compliance, dress and appearance were important indicators at the time of clinical decision making for physicians originating from urban areas than for physicians originating from rural areas. Physicians originating from urban and rural areas perceived the socioeconomic status differently.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Manzer and Bell, Smith-Oka and Shawahna et al's studies identified the adverse impact of stereotyping on HPs assessment and decision-making.
“Manzer and Bell77, Smith-Oka76 and Shawahna et al’s65 studies identified the adverse impact of stereotyping on HPs assessment and decision-making.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [65]
The Results (section 3.1) report that physicians considered patients’ socioeconomic status when choosing medicines, and the Discussion (section 4) links stereotyping to clinical decision-making. But the Discussion explicitly says the clinical benefits and risks of differential prescribing were not investigated, so the study does not establish an adverse impact from stereotyping. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The effect of patient race and socio-economic status on physicians' perceptions of patients
van Ryn, M., & Burke, J. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(99)00338-x · Cited by 1,509 · cited 4× · see citing works
“Studies showed that physicians’ perception about racial or social stereotypes leads to differentials in screening and treatment strategies and disparities in healthcare delivery [1,2].”
BackgroundInfluentialSocio-economic status of the patient and doctor–patient communication: does it make a difference?
Willems, S., De Maesschalck, S., Deveugele, M., Derese, A., & De Maeseneer, J. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2004.02.011 · Cited by 582 · see citing works
Influence of Patients' Socioeconomic Status on Clinical Management Decisions: A Qualitative Study
Bernheim, S. M., Ross, J. S., Krumholz, H. M., & Bradley, E. H. (2008) · The Annals of Family Medicine · doi:10.1370/afm.749 · Cited by 212 · cited 2× · see citing works
“Qualitative studies are helpful in eliciting preliminary broad themes, patterns and concepts in socioeconomic studies, particularly in the absence of specifically described and validated frameworks in similar context [9].”
Background
Flagged first, then by citations
Research works printed but not linked: 18
- Woo J.K., Ghorayeb S.H., Lee C.K., Sangha H., Richter S. Effect of patient socioeconomic status on perceptions of first-and second-year medical students. CMAJ, 2004, 170(13), 1915-9
- Bradley F., Elvey R., Ashcroft D.M., Noyce P. Influence of prescription charges on repeat prescribing in primary care. J. Clin. Pharm. Ther., 2007, 32(3), 269-75
- Siciliani L., Verzulli R. Waiting times and socioeconomic status among elderly Europeans: evidence from SHARE. Health Econ., 2009, 18(11), 1295-306
- Aziz Z., Iqbal J., Akram M., Anderson B.O. Worsened oncologic outcomes for women of lower socio- economic status (SES) treated for locally advanced breast cancer (LABC) in Pakistan. Breast, 2010, 19(1), 38-43
- Baig A.A., Heisler M. The Influence of Patient Race and Socioeconomic Status and Resident Physician Gender and Specialty on Preventive Screening. Semin. Med. Pract., 2008, 1(11), 27-35
- Lesen E., Andersson K., Petzold M., Carlsten A. Socioeconomic determinants of psychotropic drug utilisation among elderly: a national population- based cross-sectional study. BMC Public Health, 2010, 10, 118
- Odubanjo E., Bennett K., Feely J. Influence of socioeconomic status on the quality of prescribing in the elderly --a population based study. Br. J. Clin. Pharmacol., 2004, 58(5), 496-502
- Dean B., Barber N., Schachter M. What is a prescribing error? Qual. Health Care, 2000, 9(4), 232-7
- Duffield C. The Delphi technique: a comparison of results obtained using two expert panels. Int. J. Nurs. Stud., 1993, 30(3), 227-37
- Scott E.A., Black N. When does consensus exist in expert panels? J. Public. Health Med., 1991, 13(1), 35-9
- Hasson F., Keeney S., McKenna H. Research guidelines for the Delphi survey technique. J. Adv. Nurs., 2000, 32(4), 1008-15
- Keeney S., Hasson F., McKenna H.P. A critical review of the Delphi technique as a research methodology for nursing. Int. J. Nurs. Stud., 2001, 38(2), 195-200
- Erah P.O., Olumide G.O., Okhamafe A.O. Prescribing practices in two health care facilities in Warri; southern Nigeria: A comparative study. Trop. J. Pharm. Res., 2003, 2(1), 175-182
- Espelt A., Borrell C., Roskam A.J., Rodriguez-Sanz M., Stirbu I., Dalmau-Bueno A., Regidor E., Bopp M., Martikainen P., Leinsalu M., Artnik B., Rychtarikova J., Kalediene R., Dzurova D., Mackenbach J., Kunst A.E. Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century. Diabetologia, 2008, 51(11), 1971-9
- Hadden W.C., Pappas G., Khan A.Q. Social stratification, development and health in Pakistan: an empirical exploration of relationships in population-based national health examination survey data. Soc. Sci. Med., 2003, 57(10), 1863-74
- Kripalani S., Bussey-Jones J., Katz M.G., Genao I. A prescription for cultural competence in medical education. J. Gen. Intern. Med., 2006, 21(10), 1116-20
- Rohra D.K., Gilani A.H., Memon I.K., Perven G., Khan M.T., Zafar H., Kumar R. Critical evaluation of the claims made by pharmaceutical companies in drug promotional material in Pakistan. J. Pharm. Sci., 2006, 9(1), 50-9
- Rohra D.K., Bashir M.U., Khwaja U.A., Nazir M.R. Critical appraisal of apparently evidence-based written advertising in Pakistan. Pharm. World. Sci., 2008, 30(3), 216-21
Cited by
Sorted by citations
Job, C., Adenipekun, B., Cleves, A., Gill, P., & Samuriwo, R. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-081723 · Cited by 44 · see citing works
- Authors
- Shawahna, R., Nisar-ur-Rahman, Ahmad, M., Debray, M., Declèves, X., Yliperttula, M., & Blom, M.
- Affiliations
- University of Helsinki (FI)
- COMSATS University Islamabad (PK)
- Islamia University of Bahawalpur (PK)
- Université Paris Descartes (FR)
- Hôtel-Dieu de Paris (FR)
- Corresponding author
- Shawahna, Ramzi
- Venue
- Open Medicine
- Publisher
- Walter de Gruyter GmbH
- Published
- 2011-11-24
- Volume
- 7
- Issue
- 1
- Pages
- 129-136
- ISSN
- 1895-1058 (ISSN-L)
- 2391-5463
- OpenAlex
- W2019906575
- Cited by
- 4
- References
- 3
- Citations by year
- 2019: 1 · 2017: 1 · 2014: 1 · 2012: 1
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Open Medicine (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- socioeconomic status, prescribing patterns, physician perceptions, socioeconomic indicators, patient appearance, patient literacy, medication adherence, urban-rural differences, clinical decision-making, Lahore
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
