Can Regional Differences in Consumption of Tranquillizers and Hypnotics be explained by Variations in General Practitioners' threshold of prescribing? A Methodological Study

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Abstract
Large differences exist in the consumption of tranquillirs and hypnotics within and between countries. The present study investigates the hypothesis that regional differences in the utilization of tranquillizers and hypnotics are associated with corresponding differences in thresholds of prescribing. A questionnaire that described in a standardized manner 12 patients with a symptomatology of anxiety and insomnia was sent to all general practitioners in two regions (south/north) in Norway. In the south, tranquillizers and hypnotics are used much more frequently than in the north. Based on written simulations of patients, no differences in thresholds of prescribing was found between the general practitioners in the two regions. Neither could the doctors' choice of drugs, nor their recommendations for dosage and duration of treatment, explain the different consumption of tranquillizers and hypnotics in the two regions. The method could, however, be criticized for insuficient validity, since our case stories were less controversial with respect to psychotropic drug prescribing than intended.