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Improving doctors' prescribing behaviour through reflection on guidelines and prescription feedback: a randomised

P Lagerløv¹, M Loeb, M Andrew

¹Department of Pharmacotherapeutics, University of Oslo, Norway. per.lagerlov@netcom.no

Quality in Health Care : QHC

|September 9, 2000

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General practitioners improved prescribing quality through peer review feedback and guideline-based quality criteria. This intervention enhanced patient care by helping doctors identify and correct prescribing errors.

Area of Science:

General Practice
Clinical Quality Improvement
Evidence-Based Medicine

Background:

Translating research findings into clinical practice remains a challenge.
Existing methods like guidelines or prescription feedback have limitations.

Purpose of the Study:

To assess the impact of combined individual feedback and peer-derived quality criteria on prescribing quality.
To improve the quality of general practitioners' (GPs) prescribing.

Main Methods:

199 GPs in 32 groups were randomized for peer review meetings on asthma or urinary tract infections.
Intervention involved providing GPs with feedback on their prescribing against national guidelines and group-derived quality criteria.
Prescribing data from the year before and after the intervention were compared.

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Main Results:

The intervention group showed a statistically significant increase in acceptable prescribing for both asthma (6% relative increase) and urinary tract infections (13% relative increase).
Relative to pre-intervention values, treatment improvement was 21% for asthma and 108% for urinary tract infections.
The combined intervention effectively improved prescribing quality.

Conclusions:

Peer-derived quality criteria based on guidelines provide a framework for GPs to evaluate their prescribing.
Individual feedback helps doctors recognize and rectify prescribing practices.
This process fosters continuous improvement, leading to enhanced patient care quality.