Malone Daniel C, Liberman Joshua N, Sun Diana
Pharmacy Practice Science, College of Pharmacy, University of Arizona, 1295 N. Martin, PO Box 210202, Tucson, AZ 85721, USA.
J Manag Care Pharm. 2013 Sep;19(7):549-57. doi: 10.18553/jmcp.2013.19.7.549.
The topic of improving prescribing practices is a major focus of many national initiatives, not only to enhance the quality of health care but also to reduce medical care costs. Educational outreach (also known as academic detailing) is a type of postgraduate education where trained clinical consultants meet face-to-face with prescribers to provide one-on-one information. Ideally, such visits promote evidence-based knowledge, create trusting relationships, and induce practice change, particularly with regard to prescribing potentially interacting medications.
To evaluate the effect of an educational outreach program delivered by clinical pharmacists on reducing the rate of prescribing potential drug-drug interactions (DDIs).
The intervention was a prescriber-directed educational outreach program focused on 25 clinically important DDIs. The effect of the educational outreach was evaluated using a retrospective pre-post study design with a control group was conducted. A total of 19,606 prescribers were educated on the DDIs of interest. A control group of 19,606 prescribers, matched on prescribing volume and who did not receive the educational session were selected. Multivariate regression models were used to assess the impact of the educational program on the rate of prescribing potential DDIs.
The 2 groups were significantly different with respect to age, profession, specialty, and geographic region. At baseline, mean DDI rates per 100 drug prescriptions were 0.8 and 0.7 for prescribers who received the educational session and those who did not, respectively. Following delivery of the educational outreach program, mean potential DDI rates increased to 1.46 and 1.53 per 100 precipitant drug prescriptions, an increase of 13.9% and 9.15% for the intervention and control groups, respectively.
The current study was not able to demonstrate a significant beneficial effect of the educational outreach program on reducing the rate of prescribing potential DDIs.
改善处方行为这一主题是许多国家倡议的主要关注点，不仅旨在提高医疗保健质量，还为了降低医疗成本。教育推广（也称为学术药物推广）是一种研究生教育形式，受过培训的临床顾问与开处方者面对面交流，提供一对一的信息。理想情况下，此类拜访能促进基于证据的知识传播，建立信任关系，并促使行为改变，尤其是在开具可能相互作用药物的处方方面。
评估临床药师开展的教育推广项目对降低潜在药物相互作用（DDI）处方率的效果。
干预措施是一项针对25种具有临床重要性的DDI的开处方者指导教育推广项目。采用带有对照组的回顾性前后研究设计来评估教育推广的效果。共有19606名开处方者接受了有关感兴趣的DDI的教育。选择了19606名开处方者作为对照组，他们在处方量上匹配且未接受教育课程。使用多变量回归模型评估教育项目对潜在DDI处方率的影响。
两组在年龄、职业、专业和地理区域方面存在显著差异。在基线时，接受教育课程的开处方者和未接受教育课程的开处方者每100张药物处方的平均DDI率分别为0.8和0.7。在实施教育推广项目后，每100张引发药物处方的平均潜在DDI率分别增至1.46和1.53，干预组和对照组分别增加了13.9%和9.15%。
当前研究未能证明教育推广项目在降低潜在DDI处方率方面有显著的有益效果。
