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The effect of computer reminders on GPs' prescribing behaviour: a cluster-randomised trial.
J D Martens1, T van der Weijden, J L Severens
1Integrated Care Unit, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. jd.martens@caphri.unimaas.nl
International Journal of Medical Informatics
|June 16, 2007
Summary
Computerised reminders can help restrict unnecessary drug prescriptions in general practice. Despite high variation among doctors, these systems show potential for improving prescribing behavior.
Area of Science:
- General Practice
- Health Informatics
- Clinical Pharmacy
Background:
- Controlling drug prescribing behavior in general practice is challenging despite existing guidelines.
- Computerized reminder systems (CRS) offer a potential solution to improve adherence to prescribing guidelines.
Purpose of the Study:
- To assess the impact of implementing prescribing guidelines via a reactive computer reminder system (CRS) on general practitioners' drug-prescribing behavior.
Main Methods:
- A cluster-randomised controlled trial with an incomplete block design was conducted in the Netherlands.
- General practitioners (GPs) received reminders on specific drug classes (antibiotics, asthma/COPD, cholesterol) integrated into their information systems.
- Prescription volumes and performance indicators were the primary outcome measures.
Main Results:
- No significant differences were observed in overall prescription indicators or volumes between the intervention and control groups.
- A trend towards reduced prescription volumes was noted for certain drugs, but overall differences were not statistically significant.
- Significant improvements in adherence to guidelines were found for three specific recommendations: quinolones for cystitis, corticosteroids for COPD, and antibiotics for acute sore throat.
Conclusions:
- The study was underpowered due to high inter-doctor variation in prescribing behavior.
- Computerized reminders demonstrated a potential positive effect in restricting the use of certain non-indicated drugs in general practice.
- Further research with larger sample sizes may be needed to confirm the efficacy of CRS in modifying prescribing habits.
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