Søndergaard Jens, Andersen Morten, Vach Kirstin, Kragstrup Jakob, Maclure Malcolm, Gram Lars F
Research Unit of Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense University, Odense, Denmark.
Eur J Clin Pharmacol. 2002 May;58(2):127-32. doi: 10.1007/s00228-002-0454-5. Epub 2002 Apr 17.
To evaluate the effects of postal feedback with clinically relevant data on general practitioners' prescribing compared with feedback with aggregate data on prescribing patterns of asthma drugs.
The study was a randomised, controlled trial. The general practitioners (GPs) in the County of Funen, Denmark (292 GPs representing 178 practices) were randomised to one of three groups receiving different forms of prescriber feedback. The first group received detailed and clinically relevant data on asthma drug prescribing patterns and a guideline statement. These data included tables with counts of asthma patients following classification of each individual's consumption of inhaled beta2-agonists and use of inhaled steroids. The second group received aggregate data on asthma drug prescribing patterns and a guideline statement, and the third group received feedback on an unrelated subject and served as control for the other groups. Each GP received prescriber feedback three times within a 6-month period. The last two letters with prescriber feedback had updated information with the purpose of showing changes in prescribing patterns. Effects were followed for a period of 1 year. The main outcome measures were change in fraction of asthmatics treated with inhaled steroids and incidence rate of treatment with inhaled steroids.
The three groups had similar baseline characteristics. None of the two types of feedback on prescribing of asthma drugs had a statistically significant impact on GPs' prescribing patterns.
Mailed prescriber feedback of detailed and clinically relevant data with a guideline statement, without revealing patient identities, has little or no impact on prescribing patterns.
评估与提供哮喘药物处方模式的汇总数据反馈相比,提供具有临床相关数据的邮政反馈对全科医生处方的影响。
该研究为一项随机对照试验。丹麦菲英岛的全科医生(292名全科医生,代表178家诊所)被随机分为三组,分别接受不同形式的处方医生反馈。第一组收到关于哮喘药物处方模式的详细且具有临床相关性的数据以及一份指南声明。这些数据包括按个体吸入β2受体激动剂使用情况和吸入性糖皮质激素使用情况分类后的哮喘患者计数表格。第二组收到哮喘药物处方模式的汇总数据以及一份指南声明,第三组收到关于一个不相关主题的反馈,并作为其他组的对照。每位全科医生在6个月内收到三次处方医生反馈。最后两封带有处方医生反馈的信件包含更新信息,目的是展示处方模式的变化。随访1年观察效果。主要结局指标为接受吸入性糖皮质激素治疗的哮喘患者比例的变化以及吸入性糖皮质激素治疗的发生率。
三组具有相似的基线特征。两种关于哮喘药物处方的反馈对全科医生的处方模式均无统计学上的显著影响。
邮寄包含指南声明的详细且具有临床相关性的数据的处方医生反馈,且不透露患者身份,对处方模式几乎没有影响。