Introduction: Physician motivation and prescribing habits explore why clinicians choose certain medicines, integrating concepts like rational prescribing, pharmaceutical marketing influence, incentives, conflicts of interest, prescription patterns, drug utilization, pharmacoeconomics, and evidence-based medicine. For B. Pharm students, understanding prescriber drivers—clinical guidelines, patient expectations, drug availability, cost, promotional tactics, peer influence, and continuing medical education—is essential to promote safe, cost-effective therapy and antimicrobial stewardship. This topic also covers regulatory frameworks, drug promotional ethics, formulary management, and strategies to reduce inappropriate polypharmacy and adverse drug reactions. Grasping these factors helps pharmacists collaborate with prescribers to optimize therapeutic outcomes. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary meaning of “physician motivation” in the context of prescribing habits?
- The physician’s clinical knowledge only
- The combination of clinical, personal, social and economic factors driving prescribing decisions
- Pharmaceutical company targets and quotas
- Hospital administrative policies
Correct Answer: The combination of clinical, personal, social and economic factors driving prescribing decisions
Q2. Which of the following is a key component of rational prescribing?
- Prescribing the newest drug available
- Choosing medication based on evidence of efficacy, safety, cost and patient preference
- Following patient requests without assessment
- Maximizing pharmaceutical samples use
Correct Answer: Choosing medication based on evidence of efficacy, safety, cost and patient preference
Q3. Which promotional tactic by pharmaceutical companies most directly influences prescribing habits?
- Providing free medical textbooks only
- Sponsored continuing medical education (CME) and detail visits by medical representatives
- Public health campaigns by governments
- Generic substitution policies
Correct Answer: Sponsored continuing medical education (CME) and detail visits by medical representatives
Q4. A conflict of interest in prescribing typically refers to:
- When a doctor has multiple clinical certifications
- When personal or financial interests potentially influence clinical judgment
- When a patient requests a brand-name drug
- When pharmacy stock is low
Correct Answer: When personal or financial interests potentially influence clinical judgment
Q5. Which WHO prescribing indicator is used to measure antibiotic overuse?
- Average number of drugs per encounter
- Percentage of encounters with an antibiotic prescribed
- Percentage of drugs prescribed from essential medicines list
- Percentage of generic prescriptions
Correct Answer: Percentage of encounters with an antibiotic prescribed
Q6. What effect do patient expectations often have on prescribing behavior?
- They never affect prescribing
- They can increase likelihood of receiving antibiotics or symptomatic drugs
- They reduce prescription of controlled drugs only
- They only influence non-prescription recommendations
Correct Answer: They can increase likelihood of receiving antibiotics or symptomatic drugs
Q7. Which practice helps reduce inappropriate polypharmacy?
- Prescribing multiple brand-name drugs for the same indication
- Regular medication review and deprescribing where appropriate
- Avoiding use of treatment guidelines
- Increasing duration of all prescriptions
Correct Answer: Regular medication review and deprescribing where appropriate
Q8. What is the role of formularies in influencing prescribing habits?
- They eliminate all prescribing freedom
- They provide a list of preferred medicines guiding cost-effective and evidence-based choices
- They only list over-the-counter products
- They are used solely for hospital inventory
Correct Answer: They provide a list of preferred medicines guiding cost-effective and evidence-based choices
Q9. Which factor is least likely to promote rational prescribing?
- Access to unbiased clinical guidelines
- Frequent pharmaceutical incentives tied to sales
- Continuing medical education focused on evidence-based medicine
- Availability of drug utilization data
Correct Answer: Frequent pharmaceutical incentives tied to sales
Q10. What is “prescribing cascade”?
- Sequential use of multiple antibiotics
- When a new drug is prescribed to treat side effects of another drug
- Prescribing drugs in a therapeutic class cascade
- Prescribing increasing doses over time
Correct Answer: When a new drug is prescribed to treat side effects of another drug
Q11. How does pharmacoeconomics influence prescribing habits?
- It promotes only expensive medications
- By evaluating cost-effectiveness to guide selection of affordable therapeutic options
- It focuses solely on pharmacokinetics
- It prevents generic drug use
Correct Answer: By evaluating cost-effectiveness to guide selection of affordable therapeutic options
Q12. Which approach best counters undue pharmaceutical influence on prescribers?
- Accepting all industry gifts
- Strict disclosure policies, limits on gifts, and independent CME
- Allowing sales targets in clinical settings
- Removing clinical guidelines
Correct Answer: Strict disclosure policies, limits on gifts, and independent CME
Q13. What is an effective pharmacist action to improve prescribing quality?
- Dispensing without checking prescriptions
- Conducting medication reviews, counseling prescribers and patients, and reporting ADRs
- Replacing prescriptions with advertising materials
- Avoiding communication with prescribers
Correct Answer: Conducting medication reviews, counseling prescribers and patients, and reporting ADRs
Q14. Off-label prescribing is best defined as:
- Using a drug for an indication, dose, or age group not approved by regulatory agencies
- Prescribing only brand-name drugs
- Prescription of generic drugs only
- Following package insert exactly
Correct Answer: Using a drug for an indication, dose, or age group not approved by regulatory agencies
Q15. Which monitoring program helps control controlled substance prescribing?
- Drug utilization review (DUR)
- Prescription Drug Monitoring Program (PDMP)
- Hospital formularies only
- Essential medicines list
Correct Answer: Prescription Drug Monitoring Program (PDMP)
Q16. What is the main aim of antimicrobial stewardship related to prescribing?
- Increase antibiotic sales
- Optimize antibiotic use to minimize resistance and improve outcomes
- Prescribe antibiotics for viral infections routinely
- Restrict all antibiotic access
Correct Answer: Optimize antibiotic use to minimize resistance and improve outcomes
Q17. Which is a common unethical incentive that can alter prescribing?
- Sponsored independent clinical audits
- High-value gifts, paid travel, or direct payments from industry
- Access to peer-reviewed journals
- Free CME accredited by independent bodies
Correct Answer: High-value gifts, paid travel, or direct payments from industry
Q18. How does evidence-based medicine (EBM) impact prescribing habits?
- It encourages reliance on tradition rather than data
- EBM promotes using best available research combined with clinical expertise and patient values
- It ignores patient preferences
- It only values older clinical trials
Correct Answer: EBM promotes using best available research combined with clinical expertise and patient values
Q19. What is a key outcome of regular prescription audits?
- Increase in inappropriate prescriptions
- Identification of prescribing patterns, errors, and opportunities for improvement
- Reduction in pharmacist responsibilities
- Elimination of clinical guidelines
Correct Answer: Identification of prescribing patterns, errors, and opportunities for improvement
Q20. Which factor significantly contributes to brand prescribing over generics?
- Strict generic substitution laws
- Strong marketing of branded drugs and prescriber perceptions of quality
- High patient literacy about generics
- Availability of unbiased drug information
Correct Answer: Strong marketing of branded drugs and prescriber perceptions of quality
Q21. What role does adverse drug reaction (ADR) reporting play in prescribing?
- It has no role in prescribing habits
- It informs safety profiles, guiding prescribers to safer choices and regulatory action
- It only affects pharmacy stock levels
- It prevents any new drug approvals
Correct Answer: It informs safety profiles, guiding prescribers to safer choices and regulatory action
Q22. Which educational strategy most improves prescribing behavior?
- One-off promotional lunches with drug reps
- Interactive, case-based, evidence-focused continuing education
- Advertising through mass media only
- Providing free samples without education
Correct Answer: Interactive, case-based, evidence-focused continuing education
Q23. In drug utilization research, what does DUE stand for?
- Drug Use Evaluation
- Dosage Unit Estimation
- Direct Utilization Evidence
- Drug Utility Examination
Correct Answer: Drug Use Evaluation
Q24. Which prescribing habit increases risk of antimicrobial resistance?
- Short-course targeted therapy when indicated
- Empirical broad-spectrum antibiotic use without review
- Following local antibiograms
- De-escalation based on culture results
Correct Answer: Empirical broad-spectrum antibiotic use without review
Q25. What is the impact of socioeconomic status on prescribing?
- No impact at all
- It can affect drug affordability, adherence, and choice of generic vs brand prescriptions
- It forces prescribers to ignore guidelines
- It only affects over-the-counter purchases
Correct Answer: It can affect drug affordability, adherence, and choice of generic vs brand prescriptions
Q26. Which metric helps evaluate polypharmacy quantitatively?
- Average consultation time
- Average number of drugs per encounter
- Pharmaceutical sales volume
- Number of hospital beds
Correct Answer: Average number of drugs per encounter
Q27. What is a pharmacist’s ethical duty when encountering a suspiciously influenced prescription?
- Dispense without comment
- Clarify with the prescriber, counsel the patient, and follow reporting guidelines if needed
- Return the prescription to patient without action
- Remove the prescriber from the formulary
Correct Answer: Clarify with the prescriber, counsel the patient, and follow reporting guidelines if needed
Q28. Which regulatory measure can limit inappropriate drug promotion?
- Allow unrestricted pharmaceutical advertising to prescribers
- Strict enforcement of marketing codes, mandatory disclosure of payments, and promotional review
- Removing prescription requirements
- Prohibiting all drug information to prescribers
Correct Answer: Strict enforcement of marketing codes, mandatory disclosure of payments, and promotional review
Q29. How does clinical guideline adherence affect prescribing quality?
- It usually worsens outcomes
- Improves consistency, safety, and evidence-based care when applied appropriately
- Eliminates clinician judgment entirely
- Only increases healthcare costs
Correct Answer: Improves consistency, safety, and evidence-based care when applied appropriately
Q30. What is an appropriate pharmacist-led intervention to promote generic prescribing?
- Withholding information about generics
- Patient and prescriber education about bioequivalence, cost savings, and efficacy of generics
- Promoting only branded samples
- Encouraging prescribers to avoid switching
Correct Answer: Patient and prescriber education about bioequivalence, cost savings, and efficacy of generics
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com