Quality assurance for drug prescribing

Quality Assurance in Health Care : the Official Journal of the International Society for Quality Assurance in Health Care
S B SoumeraiJ Avorn

Abstract

This article reports the results of a critical analysis of English-language studies describing programs designed to improve physician prescribing behavior in primary care settings. Only 64% of studies met minimum research design standards, and are the basis for the results reported. The overall findings of the review confirm the conclusions of a previous evaluation of hospital-based studies. (1) The simple dissemination of printed educational materials had no detectable effect on prescribing practice when used alone in well-controlled studies. However, such educational materials do lay a necessary foundation for more personalized educational efforts. (2) Merely distributing computerized listings of patient-specific medication profiles, without specific recommendations for change, is ineffective in reducing overall drug costs or use of inappropriate drugs. Their lack of effect may be due to the large quantity and clinical irrelevance of such data. (3) Continuous computerized reminder systems have been shown to prevent omission of essential care, although such systems are effective only as long as reminders continue. This strategy has not been evaluated for its potential to reduce excessive or inappropriate drug prescribing. (4) ...Continue Reading

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