推动策略在改善医生的处方行为中的使用:系统性审查和元分析
Maya Fey Hallett1, Trine Kjær1, Line Bjørnskov Pedersen1,2
1Danish Center for Health Economics (DaCHE), Department of Public Health, University of Southern Denmark, Odense, Denmark.
概括
刺激可以影响处方决策,但其影响很小,健康结果尚不清楚. 需要进一步的研究来评估成本效益,并指导决策者在使用推动来改进处方方面进行进一步的研究.
科学领域:
- 卫生政策 卫生政策
- 行为经济学是一种行为经济学.
- 医疗信息学医学信息学
背景情况:
- nudges越来越多地用于影响医疗保健专业人员的行为.
- 处方决定是旨在改善医疗保健质量和安全的干预措施的关键目标.
研究的目的:
- 调查推推特特征与它们在影响处方决策方面的有效性之间的关联.
- 评估现有的关于处方中 nudges 的文献质量.
- 评估推动的成本效益,并提供政策建议.
主要方法:
- 在健康和社会科学数据库中进行了系统的文献搜索.
- 包括有针对处方决策的研究,使用推推和测量处方行为的研究.
- 使用元分析来确定平均效果大小,并评估出版偏差.
主要成果:
- 分析了21项研究中的25个推动,其中73%显示了统计学上显著的效果.
- 平均效应大小是标准化的平均差异-0.22.
- 研究质量有所不同,发现了出版偏差的证据;成本效益仅在33%的研究中得到评估.
结论:
- 推显示有潜力影响处方决策,但效果大小小,健康影响不确定.
- 高质量的研究设计,异质性分析和成本效益评估对于未来的研究至关重要.
- 建议对研究方案进行预注册,以减轻出版偏差.
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