Four features of the resulting transaction between patients and doctors influence prescribing: lack of clarity of strategy, including the risk of any plans being subverted by urgent demands; lack of certainty about locus of control in decision-making, especially in relation to prescribing; continuity in the doctor-patient relationship; and mutuality and trust.
Barriers to reporting included: taking responsibility for self prescribing, lack of awareness of who to tell and the specific reporting process, perceived complexity of the reporting process and fear of losing access to NHPs.
Other issues identified by inspectors included insufficient checks on patients' identity, poor recording of medical histories, inappropriate medicines being prescribed and lack of communication with the patient's GP.
Multiple factors contribute to therapy procrastination, including reluctance to embark in complex therapeutic regimens, overconfidence with prescribed treatment, lack of effective result tracking, and insufficient time at clinical visit (32).
There was no statistically significant difference across socio-economic groups in the reasons why some patients did not obtain the medicine prescribed, the lack of financial resources being the main one in all groups.
A high average number of drugs might be due to financial incentives to prescribers to prescribe more, lack of therapeutic training of prescribers, or shortage of therapeutically correct drugs.
Shipman et al [ 6] also discussed the perception of a split between responsibility for prescribing and lack of control over decision making.
Polypharmacy and irrational prescribing are exacerbated by inadequate supervision of prescribing and lack of monitoring by government, civil society, and professional bodies [ 42].
Four variables in our regression model increased the likelihood of a head injury in our study sample, male gender, younger age (( overline{mathrm{x}} ) = 82.9 years versus 86 years for all other injuries), prescribed anticoagulants and lack of pre-fall musculoskeletal conditions.
Educational interventions may have limited impact on prescribing rates if lack of guideline awareness is not the primary reason for inappropriate antibiotic prescribing.
