A Cluster Randomized Clinical Trial to Improve Prescribing Patterns in Ambulatory Pediatrics
2007

Improving Pediatric Prescribing Practices with Evidence-Based Support

Sample size: 44 publication Evidence: moderate

Author Information

Author(s): Davis Robert L, Wright Jeffrey, Chalmers Francie, Levenson Linda, Brown Julie C, Lozano Paula, Christakis Dimitri A

Primary Institution: University of Washington School of Medicine

Hypothesis

Can a computerized decision support system improve prescribing practices for common pediatric conditions in a primary care setting?

Conclusion

The use of a point-of-care evidence-based prescription writer significantly improved prescribing practices for common pediatric outpatient conditions.

Supporting Evidence

  • The intervention group improved prescribing behavior by 4%, while the control group improved by only 1%.
  • The adjusted difference in behavior change between the intervention and control groups was 8%.
  • The study showed that the intervention's effectiveness did not decrease over time.

Takeaway

Doctors used a special computer system that gave them helpful information while writing prescriptions, which made them better at choosing the right medicine for kids.

Methodology

A cluster randomized controlled trial was conducted with pediatric providers receiving evidence-based prompts during electronic prescribing.

Potential Biases

Providers may have been influenced by their previous training and experiences in academic settings.

Limitations

The study had a small number of providers and many practiced in academic settings, limiting generalizability to nonacademic practices.

Participant Demographics

36 providers at a teaching clinic and 8 providers at a private pediatric clinic, primarily serving a rural and semi-urban patient mix.

Statistical Information

P-Value

0.01

Confidence Interval

95% CI 1%, 15%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pctr.0020025

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