Where have all the babies gone? An infant care study.
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Biomedical subjects
Publications and source records attributed to A Mant.
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Information about psychotropic drug prescribing in one general practice was compared with overall information about such prescribing in Australia. Over the period 1978-81 there was a significant reduction in the number of prescriptions issued for psychotropic drugs. Prescriptions for hypnotics, sedatives and minor tranquilizers were more common than those for antidepressants or major tranquilizers. The indications for prescribing were distributed equally among three groups of conditions: psychological disorders, sleep problems and physical diseases. Patients for whom psychotropic drugs were prescribed had a greater overall morbidity and used medical care services more than other patients. Only 9% of patients in 1981 were issued with a prescription for one of the four most commonly prescribed psychotropic drugs. A relatively small proportion of patients, most of them elderly women, received the largest proportion of the prescriptions.
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Collecting information is an obsessional activity which can become an end in itself. Interpreting and presenting results in a way that others can learn from them requires reflection, selectivity and ability to accept criticism. In selecting the journal to which the article will be submitted, consider which has the most appropriate readership and ensure the article conforms to the requirements and style of that journal.
General practice research often is a description of facts rather than a prediction of outcomes. This paper discusses the need to prepare protocols, to do pilot studies (to minimise error) and to be aware of the individuality of doctors and patients. The design or model for a project must be adapted to the question being asked: the means must suit the ends.
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In summary, a systematic survey of Sydney metropolitan general practice consultations revealed an appreciable level of emotional disorder in one sixth of the patients. Doctors noted a similar number of patients in whom emotional and social factors were important in that day's consultation. There was concordance of assessment in only one third of the patients and as there are reasons for believing that the questionnaire is valid, inspection of the age and sex differences suggests that the doctors' perception of emotional problmes may be affected by cultural stereotypes of who is likely to be emotionally ill. In contrast, once cases are recognized, the provision of appropriate treatment such as counselling and drugs appears to be prudently and rationally prescribed.
Precise data on levels of prescribing of psychoactive and other drugs by general practitioners have recently become available in Australia (Rowe, 1973a, b; Bridges-Webb, 1972). However, there has been little or no research into possible determinants of prescribing behaviour, for example, age, social background, work load, the nature of the practice, education and colleague networks. Nor have the attitudes, expectations, values or information levels of general practitioners been studied. The overseas literature in this field is confusing and scanty. There would seem to be good reason to investigate these aspects in Australian practices. A pilot study carried out in Canberra in 1972 suggests that a short structured questionnaire administered in a face-to-face interview could provide the necessary data.
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