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New tools to measure discrepancy between prescribing practices and guideline recommendations
Catherine Mercier1, Jean-Pierre Boissel, Jacques Estève
1Service de Biostatistique, Hospices Civils de Lyon, Lyon, France. catherine.mercier@chu-lyon.fr
Journal of Evaluation in Clinical Practice
|August 9, 2007
Summary
This study introduces two new indices to measure how much real prescriptions differ from evidence-based treatments. Both methods effectively track changes in prescriber behavior, aiding in quality improvement initiatives.
Area of Science:
- Health Sciences
- Medical Informatics
- Pharmacoeconomics
Background:
- Assessing adherence to evidence-based treatments is crucial for healthcare quality.
- Quantifying deviations in prescribing practices requires robust methodologies.
Purpose of the Study:
- To evaluate the performance of novel indices designed to measure discrepancies between actual prescriptions and established evidence-based treatments.
- To compare the utility of additive and multiplicative indices in quantifying prescribing deviations.
Main Methods:
- Simulated prescriber deviations under various conditions, with and without evidence-based references.
- Proposed two distinct indices: an additive index and a multiplicative index.
- Compared the performance and sensitivity to change of both proposed indices.
Main Results:
- Both the additive and multiplicative indices demonstrated sensitivity to variations in prescriber behavior.
- The additive index offered a more precise analysis of deviations.
- The multiplicative index, while simpler to implement and interpret, showed greater sensitivity to change.
Conclusions:
- The developed deviation indices serve as valuable new tools for evaluating prescribing practices.
- These indices can be effectively utilized in surveys and clinical trials focused on medication prescribing behavior.
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