"Some sort of fantasy land": A qualitative investigation of appropriate prescribing in cancer care.
appropriate prescribing
cancer
irrational prescribing
quality use of medicines
rational prescribing
value frameworks
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
08
05
2019
revised:
22
08
2019
accepted:
22
08
2019
pubmed:
13
9
2019
medline:
29
7
2021
entrez:
13
9
2019
Statut:
ppublish
Résumé
Increasing the appropriateness of prescribing has long been a focus of government, non-government, and professional organizations. Progress towards this is made difficult by the fact appropriate prescribing remains inconsistently defined and is the subject of ongoing intense disagreement. In this study, we attempted to understand why this is the case within the context of oncology and haematology. We performed a qualitative empirical analysis of semi-structured interviews with 16 Australian oncologists and haematologists. We found that oncologists framed appropriate prescribing in terms of the following inter-related, and at times opposed, values: civic mindedness, hope and compassion, realism, and virtue in motivation. These values cannot be ranked a priori, and therefore, any definition of appropriate prescribing must be aligned with what communities want from their health system. When one value is privileged over another in any specific context, a compelling argument must be provided to justify the choice. In an era of shared decision making, patient rights, and high-cost medicines, we need to reassess what we mean by appropriate prescribing in cancer care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
747-754Subventions
Organisme : National Health and Medical Research Council
ID : APP1080673
Informations de copyright
© 2019 John Wiley & Sons, Ltd.
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