Physicians’ perspectives on overprescription in Austria: a cross-sectional survey

Abstract Objectives Reducing low-value care, resource overuse, and healthcare emissions are critical objectives for Austrian policymakers. Overprescription of medication contributes to public health, environmental, and economic challenges. Research in Austria is limited, often focusing on specific drugs or patient groups. This study aims to provide baseline data on overprescribing through a nationwide survey of Austrian physicians. Design & setting A cross-sectional survey was conducted among Austrian general practitioners (GPs) and specialists. Participants A total of 228 Austrian physicians participated, including GPs and specialists working in inpatient and outpatient settings. Main outcome measures Physicians’ perceptions of overprescription at the national level, within their specialties, and in personal practices; associated sociodemographic and professional factors; and the most frequently overprescribed medicines and key drivers of overprescription. Results Physicians estimated overprescription rates at 33% nationally, 26.9% within their specialties, and 16.6% in their personal practices. Key factors associated with personal overprescription included lower prescribing knowledge and being a general practitioner (GP) rather than a specialist. Physicians with in-house pharmacies reported higher rates of overprescription. Proton pump inhibitors (PPIs) and antibiotics were identified as the most frequently overprescribed drugs, driven by patient demand, time constraints, and inadequate information. Notably, only 2.87% of respondents saw a high potential for improving prescribing behaviors, while 56.94% believed this potential was low. Conclusions Overprescription remains a prevalent issue in Austria, with substantial implications for healthcare costs and environmental impact. Physicians perceive systemic overprescription as more severe than their individual practices, reflecting a common “illusory superiority” bias. Addressing patient expectations, time pressure, and knowledge gaps may mitigate overprescribing, supporting sustainable and evidence-based prescribing practices. Registration The study was registered on the OSF platform on May 6th, 2024. The registration can be viewed under the following link: https://osf.io/6xeyn/ .