Clinical effects of accreditation in general practice: a pragmatic randomized controlled study

Area of Science:

• Primary Care Research
• Health Services Research
• Quality Improvement

Background:

• Accreditation is widely used for quality improvement in general practice globally.
• Robust evidence on the clinical impact of accreditation programs remains limited.

Purpose of the Study:

• To evaluate the clinical effects of a mandatory national accreditation program in Danish general practice.
• To assess the impact of accreditation on medication use and other key clinical indicators.

Main Methods:

• Pragmatic randomized controlled trial involving Danish general practices.
• Practices randomized to accreditation in 2016 (intervention) or 2018 (control).
• Compared changes in redeemed medications, polypharmacy, NSAID use, sleeping medicine, preventive visits, annual controls, spirometry, and mortality from baseline (2014) to follow-up (2017).

Main Results:

• Accreditation significantly reduced the number of redeemed medications.
• Accreditation also led to a significant reduction in polypharmacy.
• No statistically significant effects were observed for other secondary outcomes.

Conclusions:

• This is the first randomized study demonstrating accreditation's effect on reducing medication use and polypharmacy in primary care.
• Accreditation can influence provider behavior, but the observed effects are modest and specific.
• Further research into the cost-effectiveness of accreditation programs is recommended.