The Knowledge-Practice Gap in Prescribing: A Study of Perceptual and Experiential Predictors at Asella Referral and Teaching Hospital, Ethiopia-A Cross-Sectional Study.

BACKGROUND

Generic prescribing is a cornerstone of sustainable healthcare delivery, yet provider preference for brand-name pharmaceuticals remains a widespread challenge in resource-limited settings. This study evaluated brand-name prescribing practices and identified independent predictor domains among healthcare prescribers at Asella Referral and Teaching Hospital (ARTH), Ethiopia.

METHODS

A facility-based cross-sectional study was conducted between August and October 2024, involving a census of 229 prescribers. Data were collected using structured, pretested questionnaires. Key domain scores were operationalized as continuous composite variables (1-5 Likert-type scale) to maintain data integrity. A multivariable linear regression model was estimated to identify independent associates of brand-prescribing practice following verification of classical regression assumptions.

RESULTS

Prescribers demonstrated high objective awareness of generic policies and drug efficacy (domain agreement of 76.0%); however, non-adherence to generic-favouring practices was reported by 54.2% of respondents, illustrating a marked knowledge-practice gap. The overall linear regression model was statistically significant (F (6, 222) = 44.424, p < 0.001, Adjusted R 2 = 0.533). Positive Perception of Brand Drugs (standardized β = 0.416, p < 0.001) and Work Experience (standardized β = 0.398, p < 0.001) emerged as the only significant independent predictors. Policy knowledge, pharmaceutical promotion, and patient factors did not retain statistical significance.

CONCLUSION

A clear divergence exists between regulatory policy knowledge and routine prescribing practices. Brand-name prescribing demonstrated significant positive independent associations with internalized provider perceptions and clinical tenure. Hospital leadership and policymakers should complement policy dissemination with targeted interventions addressing provider perceptions and clinical habit formation.