McCarthy Caroline, Moynagh Patrick, Mannion Áine, Wei Ashely, Clyne Barbara, Moriarty Frank
Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.
Department of Public Health & Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.
Fam Pract. 2025 Jun 4;42(4). doi: 10.1093/fampra/cmaf036.
The World Health Organisation's Medication Without Harm campaign aims to reduce severe avoidable medication-related harm by 50%. This systematic review explored the characteristics of interventions that provide visual and longitudinal feedback on prescribing (interactive dashboards), in general practice and the effect of these interventions on prescribing-related outcomes.
This systematic review was registered prospectively and reported in line with PRISMA guidelines. Multiple databases and grey literature were searched in November 2023 to identify interventional studies that explored the effect of interactive dashboards on prescribing-related outcomes in general practice. Two independent researchers conducted screening, data extraction, and risk of bias assessment. Interventions were described narratively, and a random-effects meta-analysis was performed for comparable studies.
Ten randomized controlled trials, one controlled before-and-after study, and three interrupted time series were included. Seven studies reported a significant positive effect on prescribing-related outcomes, with an effect seen more often for studies focussing on potentially inappropriate prescribing (PIP) (four out of six). Three of the eight studies that focussed on antibiotic prescribing demonstrated a significant effect. A meta-analysis of three RCTs involving 160 general practices and 198 135 patients demonstrated the overall odds of PIP was 0.92 (95%CI: 0.78-1.06, I2 = 70.1%) in the intervention compared to the control group.
Interactive dashboards show promise for supporting safe and effective prescribing in general practice, but current evidence is inconclusive. Future research should focus on developing core outcome sets to facilitate future meta-analyses of effectiveness as well as optimizing their implementation and understanding how to sustain user engagement.
世界卫生组织的“无害用药”运动旨在将严重的可避免的用药相关伤害降低50%。本系统评价探讨了在全科医疗中提供处方可视化和纵向反馈的干预措施（交互式仪表盘）的特点，以及这些干预措施对处方相关结果的影响。
本系统评价前瞻性注册，并按照PRISMA指南报告。2023年11月检索了多个数据库和灰色文献，以识别探讨交互式仪表盘对全科医疗中处方相关结果影响的干预性研究。两名独立研究人员进行筛选、数据提取和偏倚风险评估。对干预措施进行叙述性描述，并对可比研究进行随机效应荟萃分析。
纳入了10项随机对照试验、1项前后对照研究和3项中断时间序列研究。7项研究报告了对处方相关结果有显著的积极影响，在关注潜在不适当处方（PIP）的研究中更常出现这种效果（6项中的4项）。8项关注抗生素处方的研究中有3项显示出显著效果。一项对涉及160家全科医疗诊所和198135名患者的3项随机对照试验的荟萃分析表明，与对照组相比，干预组中PIP的总体比值比为0.92（95%CI：0.78 - 1.06，I² = 70.1%）。
交互式仪表盘有望支持全科医疗中的安全有效处方，但目前的证据尚无定论。未来的研究应侧重于制定核心结局集，以促进未来对有效性的荟萃分析，以及优化其实施并了解如何维持用户参与度。
