Evaluation of a newsletter in altering physicians' prescribing patterns

Various techniques have been utilized by pharmacists to alter physicians' prescribing patterns in order to reduce drug costs. This study was designed to determine if a pharmacy newsletter alone could persuade physicians to change from intravenous to oral metronidazole as soon as clinically indicated. Oral metronidazole is well absorbed, reaches adequate bactericidal levels in the serum, and is approximately one-tenth the cost of the intravenous form. Thirty-four patients' charts were examined retrospectively over a two month period to determine the incidence of overprescribing of intravenous metronidazole. It was found that 31% of intravenous doses could have been given orally. This would have resulted in a cost saving of $1,863.25. Metronidazole's excellent oral bioavailability and the projected cost savings of using oral rather than IV metronidazole were presented in a newsletter distributed to all physicians. The charts of 24 patients who received intravenous metronidazole within two months after the newsletter's distribution were reviewed. There was no significant change in the prescribing of intravenous metronidazole. Further study is required to determine the cost-effectiveness of a newsletter as the sole method of influencing physician prescribing patterns.