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Related Experiment Videos

Do decision support systems influence variation in prescription?

Judith D de Jong1, Peter P Groenewegen, Peter Spreeuwenberg

  • 1NIVEL-Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, the Netherlands. j.dejong@nivel.nl

BMC Health Services Research
|February 3, 2009
PubMed
Summary

Computerized decision support systems (DSSs) help general practitioners (GPs) prescribe more in line with guidelines. However, using DSSs did not reduce prescribing variation among GPs.

Related Experiment Videos

Area of Science:

  • Health Informatics
  • General Practice
  • Clinical Decision Support

Background:

  • Translating scientific evidence into clinical practice remains a challenge.
  • Intervention strategies, including educational and directive approaches, have shown limited success in modifying physician behavior.
  • Computerized decision support systems (DSSs) offer a direct intervention within the physician's workflow.

Purpose of the Study:

  • To evaluate the impact of a DSS on general practitioners' (GPs) adherence to prescribing guidelines.
  • To determine if the use of a DSS reduces variation in prescribing patterns among GPs.

Main Methods:

  • Analysis of data from the Second Dutch National Survey of General Practice (2001).
  • Inclusion of 133 physicians and 85 practices, covering 82 diagnoses and 749,811 patient contacts.
  • Multilevel analyses comparing daily DSS users with non-users, assessing prescription adherence and prescribing variation (Herfindahl-Hirschman Index).

Main Results:

  • GPs utilizing the DSS daily demonstrated higher adherence to its recommended prescribing advice.
  • No significant difference in prescribing variation (Herfindahl-Hirschman Index) was observed between GPs using the DSS and those who did not.
  • Prescribing variation remained comparable regardless of DSS usage.

Conclusions:

  • DSSs can effectively increase physician adherence to clinical guidelines.
  • The implementation of DSSs in general practice does not inherently lead to a reduction in prescribing variation.
  • While DSSs aid in guideline implementation, they may not be sufficient to limit practice variation.