{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:41:09Z","timestamp":1790462469139,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["89726186"],"award-info":[{"award-number":["89726186"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2024,4,8]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Overuse of medical care is a pervasive problem. Studies using hypothetical scenarios suggest that physicians\u2019 risk literacy influences medical decisions; real-world correlations, however, are lacking. We sought to determine the association between physicians\u2019 risk literacy and their real-world prescriptions of potentially hazardous drugs, accounting for conflicts of interest and perceptions of benefit\u2013harm ratios in low-value prescribing scenarios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting and sample<\/jats:title>\n                  <jats:p>Cross-sectional study\u2014conducted online between June and October 2023 via field panels of Sermo (Hamburg, Germany)\u2014with a convenience sample of 304 English general practitioners (GPs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>GPs\u2019 survey responses on their treatment-related risk literacy, conflicts of interest and perceptions of the benefit\u2013harm ratio in low-value prescribing scenarios were matched to their UK National Health Service records of prescribing volumes for antibiotics, opioids, gabapentin and benzodiazepines and analysed for differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>204 GPs (67.1%) worked in practices with \u22656 practising GPs and 226 (76.0%) reported 10\u201339 years of experience. Compared with GPs demonstrating low risk literacy, GPs with high literacy prescribed fewer opioids (mean (M<jats:italic>)<\/jats:italic>: 60.60 vs 43.88 prescribed volumes\/1000 patients\/6 months, p=0.016), less gabapentin (M: 23.84 vs 18.34 prescribed volumes\/1000 patients\/6 months, p=0.023), and fewer benzodiazepines (M: 17.23 vs 13.58 prescribed volumes\/1000 patients\/6 months, p=0.037), but comparable volumes of antibiotics (M: 48.84 vs 40.61 prescribed volumes\/1000 patients\/6 months, p=0.076). High-risk literacy was associated with lower conflicts of interest (\u03d5 = 0.12, p=0.031) and higher perception of harms outweighing benefits in low-value prescribing scenarios (p=0.007). Conflicts of interest and benefit\u2013harm perceptions were not independently associated with prescribing behaviour (all ps &gt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions and relevance<\/jats:title>\n                  <jats:p>The observed association between GPs with higher risk literacy and the prescription of fewer hazardous drugs suggests the importance of risk literacy in enhancing patient safety and quality of care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjqs-2023-016979","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T13:25:53Z","timestamp":1713360353000},"page":"634-641","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["General practitioners\u2019 risk literacy and real-world prescribing of potentially hazardous drugs: a cross-sectional study"],"prefix":"10.1136","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-2673","authenticated-orcid":false,"given":"Odette","family":"Wegwarth","sequence":"first","affiliation":[{"name":"Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions, Charit\u00e9 Universit\u00e4tsmedizin Berlin Campus Charite Mitte, Berlin, Germany"},{"name":"Adpative Rationality, Max-Planck-Institute for Human Development, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy C","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine, Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5127-4728","authenticated-orcid":false,"given":"Ben","family":"Goldacre","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-0495","authenticated-orcid":false,"given":"Claudia","family":"Spies","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Campus Charit\u00e9 Mitte and Campus Virchow-Klinikum, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge A","family":"Giese","sequence":"additional","affiliation":[{"name":"Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions, Charit\u00e9 Universit\u00e4tsmedizin Berlin Campus Charite Mitte, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"2025090410560046000_33.10.634.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32585-5"},{"key":"2025090410560046000_33.10.634.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30947-3"},{"key":"2025090410560046000_33.10.634.3","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-5-201203060-00005"},{"key":"2025090410560046000_33.10.634.4","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-11-916"},{"key":"2025090410560046000_33.10.634.5","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10391469"},{"key":"2025090410560046000_33.10.634.6","doi-asserted-by":"crossref","first-page":"369","DOI":"10.2174\/1570162X13666150511125200","article-title":"What counselors tell low-risk clients about HIV test performance","volume":"13","author":"Prinz","year":"2015","journal-title":"Curr HIV Res"},{"key":"2025090410560046000_33.10.634.7","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-35585-z","article-title":"US Gynecologists\u2019 estimates and beliefs regarding ovarian cancer screening\u2019s effectiveness 5 years after release of the PLCO evidence","volume":"8","author":"Wegwarth","year":"2018","journal-title":"Sci Rep"},{"key":"2025090410560046000_33.10.634.8","unstructured":"Eddy DM . Variations in physician practice: the role of uncertainty. In: Dowie J , Elstein AS , eds. Professional judgment A reader in clinical decision making. 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Tracking medicine: a researcher's quest to understand health care; Oxford University Press; 2010."},{"key":"2025090410560046000_33.10.634.24","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-11-199712010-00003"},{"key":"2025090410560046000_33.10.634.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.01.013"},{"key":"2025090410560046000_33.10.634.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-026886","article-title":"Do doctors in dispensing practices with a financial conflict of interest prescribe more expensive drugs? 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