The Role of Implicit Bias in Shaping Medication Prescribing Practices: A Scoping Review

BACKGROUND: The most significant risk of implicit bias is that it is often unrecognized and unaddressed. Unidentified implicit bias in health care can hinder the appropriate prescribing of medications in underserved groups. This requires the strategic measurement of implicit bias to assess its impact, using methods such as the implicit association test (IAT). This scoping review aims to identify patterns of implicit bias in medication prescribing to inform interventions that promote equitable prescribing practices. METHODS: A comprehensive literature search was conducted across PubMed, Embase, and Web of Science, with eligibility criteria based on the PICOT (Patient/Population, Intervention, Comparison, Outcome, and Time) framework. Studies were included if they measured implicit bias and medication prescribing patterns among adult health care providers and health profession students. RESULTS: A total of 104 studies met our inclusion and exclusion criteria; 22 were selected for full-text review, comprising 11 IAT-focused and 11 non-IAT-focused studies. All studies identified the presence of racial implicit bias, with three also including gender and one including socioeconomic class. CONCLUSION: The findings regarding the influence of implicit bias on medication prescribing practices were mixed, with evidence suggesting that factors such as disease state and type of implicit bias may contribute to this relationship.