Prescribers’ perspectives of the socioeconomic status and important indicators affecting prescribing behavior in a developing country

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.