• David Lim, Jon D Emery, Janice Lewis, and V Bruce Sunderland.
• School of Public Health, Curtin University, Perth, WA. david.limATcurtin.edu.au
• Med. J. Aust. 2011 Aug 15; 195 (4): 172-5.

ObjectiveTo evaluate the prescribing practices of Australian dispensing doctors (DDs) and to explore their interpretations of the findings.Design, Participants And SettingSequential explanatory mixed methods. The quantitative phase comprised analysis of Pharmaceutical Benefits Scheme (PBS) claims data of DDs and non-DDs, 1 July 2005-30 June 2007. The qualitative phase involved semi-structured interviews with DDs in rural and remote general practice across Australian states, August 2009-February 2010.Main Outcome MeasuresThe number of PBS prescriptions per 1000 patients and use of Regulation 24 of the National Health (Pharmaceutical Benefits) Regulations 1960 (r. 24); DDs' interpretation of the findings.Results72 DDs' and 1080 non-DDs' PBS claims data were analysed quantitatively. DDs issued fewer prescriptions per 1000 patients (9452 v 15 057; P = 0.003), even with a similar proportion of concessional patients and patients aged > 65 years in their populations. DDs issued significantly more r. 24 prescriptions per 1000 prescriptions than non-DDs (314 v 67; P = 0.008). Interviews with 22 DDs explained that the fewer prescriptions were due to perceived expectation from their peers regarding prescribing norms and the need to generate less administrative paperwork in small practices.ConclusionsContrary to overseas findings, we found no evidence that Australian DDs overprescribed because of their additional dispensing role.

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